Preamble

The House met at hall-past Two o'clock

PRAYERS

[MR. SPEAKER in the Chair]

Oral Answers to Questions — WALES

Labour Statistics

Mr. Rowlands: To ask the Secretary of State for Wales how many people are currently unemployed in Merthyr and Rhymney; and what estimate he has of the number of job vacancies available.

The Secretary of State for Wales (Mr. David Hunt): Before I answer that question and with your leave, Mr. Speaker, I wish to say that our thoughts are very much with the people of Aberfan. In saying that, I know that I speak not only for the House, the people of Wales and the people of the rest of the United Kingdom, but for people across the world.
The figures are 7,394 and 519.

Mr. Rowlands: May I thank the Secretary of State for those kind and sympathetic words which will be greatly appreciated in Aberfan? It has been my privilege to represent Aberfan in this House for the best part of 20 of those 25 years. I have witnessed the determination, courage and commitment of the community to rebuild itself. Our thoughts are certainly with the many personal friends and families who have to live with those terrible memories and grievous loss.
May I remind the Secretary of State that the pit was closed two years ago and that in March the deep navigation pit next door at Treharris was closed? Next month Penallta is to close, thus leaving the south-east Wales coalfield with only two pits, Taff Merthyr and Tower. Will the Secretary of State give us his personal assurance that he will not be party to any coal board privatisation which, according to the Rothschild report, would mean the complete closure of all pits in south-east Wales, thus destroying the true great mining tradition?

Mr. Hunt: I very much join with the remarks of the hon. Gentleman at the outset of his supplementary question.
Only this morning I was reflecting that in 1947, at the time of nationalisation, we had 229 pits in Wales whereas now we have five and that in 1947 we had 124,000 people employed whereas now we have just over 1,000. From those statistics people can see the tremendous transformation that has take place in Wales. Equally, it imposes an obligation on the Government not only to sustain the coal industry—

Mr. Rowlands: The Welsh coal industry.

Mr. Hunt: Yes, the Welsh coal industry. The first pit where I went underground was Point of Air in north Wales —which sometimes we forget is one of the Welsh coal mines. We must also provide the job opportunities that will be needed in the Wales of the future.

Mr. Barry Jones: I thank the Secretary of State for his remarks about the community of Aberfan and for associating all of his Department and the people of Wales with what he said.
I welcome the Dow Corning investment in the Vale of Glamorgan, which is a credit to my hon. Friend the Member for Vale of Glamorgan (Mr. Smith) and all concerned. Has not the Secretary of State failed to appreciate the seriousness of the situation over which he presides? I am talking about the 12 successive monthly increases in unemployment in Wales, the 40 per cent. rise in unemployment in Wales this year and now a spate of redundancies that are causing grave concern. Will he admit that in communities such as Aberdare, Merthyr, Bridgend, Rhondda, Pontypridd and Swansea the situation is a national disgrace? Will he tell us now what is his strategy to make Wales the best and most successful economy in Europe?

Mr. Hunt: I appreciate the hon. Gentleman's opening remarks.
I take this opportunity to say that I am delighted today to be able to announce a major investment package of more than £14 million, involving the creation of 470 jobs. Each of the projects is backed with regional selective assistance from the Welsh Office. I hope that that communicates to the hon. Gentleman that not only are we determined to provide more job opportunities, but we are putting our money where our mouth is.

Mr. Ron Davies: To ask the Secretary of State for Wales what proposals he has to alleviate the current levels of unemployment in (a) Rhymney Valley, (b) Mid Glamorgan and (c) Wales.

Mr. David Hunt: The range of measures operated by the Welsh Office, the Welsh Development Agency and all Government agencies are aimed at combating unemployment. We shall continue to look for and respond swiftly to opportunities that have the potential to reduce unemployment.

Mr. Davies: Many of my hon. Friends will join me in my constituency at Ystrad Mynach to commemorate the closure of Penallta colliery which means the loss of 300 jobs and the end of the coal industry in the Rhymney valley. Since even the former Prime Minister has now acknowledged that she is "painfully aware" of the destructive nature of the Government, will the Secretary of State, as an act of contrition and a public apology to the people of Wales for the past 12 years, care to join us at that commemoration next week?

Mr. Hunt: I have nothing to apologise for. It is most discourteous of the hon. Gentleman to try to lay at the door of a Conservative Government what has happened in the coal industry. I have already given the figures on that industry and he will know from them that far more pits were closed under Labour Governments than under Conservative ones. During the 1980s a series of Conservative Governments brought new jobs to different parts of Wales. They have transformed Wales with the


biggest land clearance programme in Europe. It is about time that the hon. Gentleman acknowledged that, just as the 1980s were the decade in which Wales was transformed, the 1990s will be the decade of opportunity.

Mr. Gwilym Jones: Is not the best way in which to continue to expand the soundness of the Welsh economy not to follow the moans and groans of the Opposition, but to continue the pragmatic and enlightened approach that my right hon. Friend and his predecessor have followed? Those are not my comments, but those of the hon. Member for Vale of Glamorgan (Mr. Smith) as reported on "Wales on Sunday".

Mr. Hunt: I take the opportunity to thank the hon. Member for Vale of Glamorgan (Mr. Smith) for his kind remarks about the enlightened policies of myself and my predecessor.

Mr. Foot: These shameful unemployment figures are far higher than those at any time in the post-war period when a Labour Government were in power. How much is the latest increase in unemployment due to the abandonment of effective regional policies by the right hon. Gentleman and his predecessors which has meant that, for Wales, the slump goes deeper and it will take us longer to get out of it? Does the right hon. Gentleman agree that the abandonment of those regional policies was done in defiance of recommendations from the Opposition?

Mr. Hunt: Among the package of announcements that I am delighted to be making today is one of a joint venture between Germany and Sweden in the right hon. Gentleman's constituency for the manufacture of automotive exhaust downpipes and silencers at Tredegar. There is another project relating to the tie and neckwear factory at Nantyglo. Those two projects alone will create nearly 100 jobs. I hope that that will demonstrate to the right hon. Gentleman our determination to continue to bring job opportunities to Wales and his constituency.

Mr. Raffan: Will my right hon. Friend join me in welcoming today's announcement by Knitmesh in my constituency that it is to create 67 new full-time jobs and 58 part-time ones? Will he also join me in congratulating British Aerospace at Broughton on securing the Japanese air self-defence contract with 27 British Aerospace jets? Does my right hon. Friend agree that those announcements bode extremely well for jobs in north-east Wales?

Mr. Hunt: I am glad to respond to my hon. Friend's invitation to welcome the investment by Knitmesh of nearly £2 million, about which I am delighted. I was also extremely pleased to be present, with the hon. Member for Alyn and Deeside (Mr. Jones), at the opening of the new wing factory at British Aerospace and I was delighted to hear of the good news since. All that represents good prospects for the future.

Water Quality

Mr. Win Griffiths: To ask the Secretary of State for Wales what progress has been made in implementing the EC directives on bathing water quality and drinking water quality.

The Parliamentary Under-Secretary of State for Wales (Mr. Nicholas Bennett): We brought both directives into

United Kingdom legislation and have given major investments to water undertakings to ensure that the directives are met.

Mr. Griffiths: Yes, but the Minister must be aware that we have not met the deadlines set in the directives. I had hoped that this afternoon the Minister might have been able to tell me when, as a result of discussions with the chairman of Welsh Water, he expects the bathing water and tap water quality directives to be met in Wales. Has there been any slippage, as I believe, in the investment programme announced on the privatisation of Welsh Water? Perhaps the Minister does not appreciate the seriousness of the problem, but in parts of Cardiff more than 20 per cent. of the water has lead levels above the safety limit. Does he agree that it would be far better for Welsh Water to invest money in improving water quality than in buying shares in South Wales Electricity and other such companies?

Mr. Bennett: Welsh Water is investing £1·8 billion over 10 years in the water industry in Wales—that is £500,000 every day for 10 years—and it is doing an excellent job. Its programme will mean that shortly no lead pipes will be in Welsh Water's control and it has put forward a £10 million programme to help householders to get rid of lead pipes in their homes.

Mr. Grist: Will my hon. Friend confirm that Britain is the most successful EC country in providing decent. clean water and that we are honest in our testing, we publicise our testing and we obey the directives, unlike some of our partners?

Mr. Bennett: My hon. Friend is absolutely right, because 99 per cent. of Welsh drinking water already meets or exceeds EC standards. It is distressing that the Labour party spends all its time running down Britain when our record is much better than that of our European partners. One need only smell the Rhine at Cologne or go on the beaches in the Mediterranean or Greece to see that our European partners have a long way to go to catch up with British standards.

Mr. Wigley: Does the Minister accept that it is unreasonable to fund that large expenditure, which must be met, from the charges made for water? Does he accept that the profits retained to fund such improvements in capital works have driven up the price of Welsh water to the extent that some of my constituents, pensioners living in single-bedroomed flats, pay £220 a year in water charges? Is not that ridiculous? The Government must look at means of funding general improvement work other than through the taxation now charged by Welsh Water.

Mr. Bennett: The hon. Gentleman must look at the facts. Welsh Water is spending £108—

Mr. Wigley: Answer the question.

Mr. Bennett: I am answering the question, if the hon. Gentleman would listen. Welsh Water is investing £108 for every £100 that it collects in charges. The average charge to consumers in Wales is 55p per day, which is a small charge. I admit that, to some people, it is a considerable amount to collect in one lump, but it can be paid over a period of 10 months. It is important that we get over the period of neglect of the last Labour Government, when investment fell to an all-time low.

Labour Statistics

Mr. Roy Hughes: To ask the Secretary of State for Wales what is the most recent unemployment figure for Wales.

Mr. David Hunt: On 12 September, the latest seasonally adjusted figure for unemployment was 120,200.

Mr. Hughes: Does the Secretary of State appreciate that it will cost £21 billion to keep 2·5 million people on the dole this year, 120,000 of whom are in Wales? In the Newport travel-to-work area, the unemployment rate is now 11·7 per cent., with 27 people competing for each vacancy. Is not that a disgraceful record for the Government after 12 years and is not it time for the people of the country to be allowed to give their verdict on that record?

Mr. Hunt: The hon. Gentleman will recognise that five years ago the figure was 180,000. One area where there has been a substantial reduction has been in the long-term unemployed. I am sad that the hon. Gentleman did not take the opportunity to highlight the successes that have taken place in and around his constituency through new investment and the marvellous news about Imperial park. Imperial college has decided to set up a science park in the area around the hon. Gentleman's constituency. That is marvellous news for the future of Wales.

Mrs. Clwyd: If the Secretary of State is so proud of his record, will he explain why, under three successive Secretaries of State, unemployment in the Cynon Valley has been the highest in Wales? If he and the Coal Board have nothing to hid on privatisation, why was I denied access to the only remaining pit in the Cynon Valley, Tower colliery, the week before last? Will he give the men at Tower colliery, which is now making a profit, a categorical assurance that, despite two or three previous redundancies in the coal industry, they now have a secure future in the Tower colliery in Cynon Valley?

Mr. Hunt: Whether or not the hon. Lady can gain access to the colliery is a matter for British Coal, not me. I regret that she failed to repeat the words of the chief executive of Cynon Valley council who said that Cynon Valley was rapidly becoming the land of high-tech investments. It is exciting that we are now seeing a number of new investments—

Mrs. Clwyd: Come on!

Mr. Hunt: The hon. Lady should not downgrade the achievements of her council, which is doing extremely well in attracting new investment. I am delighted about the investment—the joint venture of the Gooding Sanken group—which is to take place next year.

Mr. Geraint Howells: My colleagues and I would like to be associated with the sentiments expressed earlier this afternoon.
I am sure that the Secretary of State is aware that the people of Pembrokeshire and Cardiganshire are disappointed that, after 12 years of Tory rule, Fishguard is at the top of the unemployment league with a rate of 18 per cent. and Cardigan has 17 per cent. That is not a very good Government record and my constituents are disturbed.
How long will they have to wait before unemployment levels move down the league and the average rate is closer to that of other constituencies—6 per cent?

Mr. Hunt: I much appreciate the hon. Gentleman's first remarks.
As for Fishguard and Holyhead, I greatly regret that there are some traditional pockets of high unemployment in Wales and we must use every way possible to feed new opportunities through to those districts. I hope that the hon. Gentleman will pay tribute to the substantial investment being made in north Wales, through the A55 corridor of opportunity. I am delighted that my right hon. Friend the Minister of State will be present at the opening of the Conwy tunnel. I am also delighted at the M4 development in the south, towards west Wales, which will open up many opportunities in south and west Wales.

Mr. Murphy: Bearing in mind all the talk that we have heard this afternoon about the appalling level of unemployment in the Principality, is not it exactly the wrong time for the Chief Secretary to the Treasury to be asking for major cuts in the training budget? Now that the Secretary of State has responsibility for training in Wales, will he confirm that, in Wales, career development loans and business enterprise training will continue? Most importantly, precisely what proportion of the £100 million cuts in youth training and the £100 million cuts in employment training will be borne by the people of Wales?

Mr. Hunt: I am glad that the hon. Gentleman has raised the subject of training. As he will know, resources are a matter for discussion within government and the House will be informed about that subject in the autumn statement. I am glad that the hon. Gentleman mentioned training, because I regard a key move to be the Prime Minister's transfer of the responsibility for training from the Department of Employment to the Welsh Office. It gives us a marvellous opportunity in Wales and I have set up a training, enterprise and education unit within the Welsh Office which seeks to bring together those three key sectors of responsibility to formulate future training policies with the training and enterprise councils—the first of which in the United Kingdom was set up in Wales. Those are exciting developments.

Job Losses

Mr. Flynn: To ask the Secretary of State for Wales what is his estimate of the total number of jobs that have been lost by outward investment, or the export of existing jobs overseas, in the past 12 months.

The Minister of State, Welsh Office (Sir Wyn Roberts): We do not hold those figures, but I can tell the hon. Gentleman that nine inward investment projects have been secured for his constituency in the past 18 months, promising some 450 jobs and that the magnificent Imperial science park being established there will create many hundreds of top-quality new jobs in addition to those provided by the new Patent Office.

Mr. Flynn: While the loss of jobs from Newport and Llanelli to firms overseas is serious enough, what is more worrying is the loss of jobs from Newport to other parts of the United Kingdom. Is the Minister aware of the claims made by the previous Secretary of State for Wales that the Toyota jobs were in the bag for Wales until the previous


Prime Minister called in the Toyota boss and told him that she wanted the jobs to be located in Derby because of the large number of marginal seats in that district? She also promised to match the grant available in Wales for Derby.
Is the Minister further aware that the Prime Minister flatly denied the claim and told me that the Government neither encouraged nor discouraged Toyota in its choice of site? Will the Minister guarantee today that should future jobs bonanzas come to Wales they will not be stolen by Huntingdon man using the Huntingdon charter to site such jobs in Huntingdon?

Sir Wyn Roberts: The hon. Gentleman has revealed himself as rather smaller-minded than I had thought. Of course I have seen the Prime Minister's reply to him—it contains what I have already said. The eventual decision was for Toyota itself to take. There were competing claims within the United Kingdom and overseas. That is entirely credible and, bearing in mind the fact that Toyota did not require Government financial assistance, it is inconceivable that any pressure could have been brought to bear on it.
To listen to the hon. Gentleman one would think that we in Wales had some God-given right to every investment. We do not.

Mr. Dickens: Does my right hon. Friend accept that inward investment in the United Kingdom in general and in Wales in particular was outstanding last year? What have been the investment opportunities in the first six months of this year?

Sir Wyn Roberts: My hon. Friend is absolutely right. We have done extremely well with inward investment. Last year about 147 projects were secured, promising 15,000 new or safeguarded jobs and capital investment of about £585 million. In the first six months of this year we have had 102 projects, promising 10,800 jobs and about £735 million worth of investment. It is incredible that one has to go to a rival region such as Catalonia, which I visited last week, to hear just how well we are doing in Wales.

Mr. John P. Smith: It is true that I will always warmly welcome good news for my constituency wherever it comes from, especially good news relating to public money being used to pave the way for investment. It is a pity, however, that many of my colleagues cannot enjoy such good news because of what is happening in Wales.
In the light of the announcement about Barry, may we look forward to an early decision on the establishment of a rail link to Cardiff-Wales airport which will further increase investment opportunities in Barry and the rest of south Wales?

Sir Wyn Roberts: The hon. Gentleman and I have been over this ground on a number of occasions and I know that he knows only too well that this is primarily a matter for South Glamorgan county council to put forward in conjuction with British Rail. Then, if such a proposal is made, we can consider it.

Citizens Charter

Mr. Hind: To ask the Secretary of State for Wales if he will make a statement on the numbers of representations he has received from the people of Wales on the implementation of the citizens charter in Wales.

Mr. Nicholas Bennett: So far we have had more than 70 representations, we have published 28,000 copies of the citizens charter in Wales and we have already published the education charter for parents. Shortly, we hope to publish the tenants and patients charters.

Mr. Hind: Will my hon. Friend take every opportunity to remind the parents of Wales that through the parents charter they will have greater choice, a vastly increasing flow of information from schools and a much-improved say in the running of those schools and the education of their children? That contrasts with what the Labour party would give them: a reduction in say and choice and a great reduction in the powers that they as parents would enjoy.

Mr. Bennett: I could not agree more. Not only would the Labour party ensure that parents did not get information about exam results—it opposed the idea when the relevant Bill was passing through the House—but it would abolish city technology colleges, do away with grant-maintained schools and get rid of the assisted places scheme. The whole policy of the Labour party is to scrap, demolish and oppose. It has no constructive suggestions on education.

Mr. Anderson: Will the aggrieved private citizen in Wales be able to complain about evasions and delay by the Welsh Office? The aggrieved people of west Wales have been waiting three years since they were promised that the second cardiac unit would be sited in west Wales. Will they be able to complain about that delay in spite of the Welsh Office promise?

Mr. Bennett: If the people of Wales have a complaint about the Welsh Office they can complain to the parliamentary ombudsman. My job is to ensure that all the policies of the Welsh Office are put forward as speedily as possible for the people of Wales.

Mr. Alex Carlile: Will the Welsh Office publish a railway sufferers charter for Wales pointing out that the considerable investment in industry between Shrewsbury and Aberystwith has been met by British Rail by the withdrawal of all InterCity services west of Wolverhampton? Will that railway sufferers charter also ensure that people can not only complain, satisfying though that is, but can see some improvement in the abominable rail services west of Shrewsbury?

Mr. Bennett: I have considerable sympathy with what the hon. and learned Gentleman says about British Rail, and I have recently had cause to complain about the west Wales lines. The best thing that can happen to British Rail for the passengers is a move towards privatisation so that passengers can have more say and more control over their services.

Health Service

Mr. Denzil Davies: To ask the Secretary of State for Wales when he next intends to meet the chairmen of the health authorities to discuss the future of the health service in Wales.

Mr. David Hunt: On 20 November.

Mr. Davies: When the Secretary of State meets those chairmen, will he discuss with the chairman of the East Dyfed health authority the proposal to close the Mynydd


Mawr hospital in my constituency? That hospital is for the elderly chronically sick, and there is a great danger that services for those people, along with the phrase itself, are beginning to disappear. Is the Secretary of State aware that however good acute and rehabilitation services, and whatever the expectation of life, unfortunately in the last three years of their lives many people will need to be looked after in hospital? Will the right hon. Gentleman look with disfavour upon that proposed closure and on any proposal to close a hospital for the elderly chronically sick?

Mr. Hunt: I understand that East Dyfed district health authority is consulting on the transfer of services for the elderly and that consultation ends on 2 November. If the community health council objects, the proposals will be decided by the Secretary of State.

Mr. Rogers: When the Secretary of State meets the chairmen of the health authorities will he discuss with the chairman of Mid Glamorgan health authority the delays in hospital reorganisation in the Taff Ely—Rhondda area, which have led to considerable underprovision? Although a new hospital is opening, there will be a substantial loss of beds in the area. I know that the Secretary of State has made arrangements for a meeting on 24 November and I am sure that he will receive with sadness, as will Opposition Members, the news that Mrs. Mattie Collins, the leader of Rhondda borough council for many years, died yesterday. At that meeting, which I hope to attend in her place, will the Secretary of State have an answer about this hospital reorganisation?

Mr. Hunt: At that meeting I look forward to discussing these issues with the hon. Gentleman. I join the hon. Gentleman in paying tribute to the life of Mrs. Mattie Collins, who did such a tremendous amount for her area. I know that the news of her death will have been received with great sadness in all parts of the House.

Mr. Raffan: Will my right hon. Friend join me in congratulating the doctors, nurses and ancillary staff at Glan Clwyd and Wrexham Maelor hospitals on treating 1,000 more patients this year than originally expected? Does my right hon. Friend agree that that is yet further evidence of the excellent national health service available to those living in the Clwyd health authority area?

Mr. Hunt: I could not agree more with my hon. Friend. The health service in Wales is now treating a record number of patients, it has a record level of funding and the proposed reforms are receiving enthusiastic support from a number of health service managers because they will ensure that the record level of funding is spent in the best possible way for the patients.

Mr. Gareth Wardell: When the Secretary of State meets the chairmen of the health authorities in Wales, will he make three things abundantly clear to them? First, will he make it clear that they are responsible, with a continuing role, for looking after the long-term intensive care of the elderly? Secondly, will he ensure that funds are available so that general practitioners can refer their patients to the hospital that they deem to be appropriate for their treatment? Thirdly, will he look again at the position of the orthopaedic hospital Rhydlafar, in Cardiff, to ensure that money is made available so that those arriving for major hip and knee operations are not referred back to their

general practitioners? The money ran out before the summer recess, which is a cruel deception when that centre is available.

Mr. Hunt: On the hon. Gentleman's third point, he will know that we received a tremendous number of bids for waiting times for 1991–92, requiring funding of about £5 million against the £1·3 million that was available. Against that background, we were unable to support the bid in full. I am not sure whether the hon. Gentleman knew this, but I am happy to tell him that a further £64,000 to support 40 additional operations in 1991–92 will be made available. I will respond to the hon. Gentleman on his other points.
The hon. Gentleman spoke about funding. I do not want any impression to be given—I want only the facts to be made clear. They are that in 1979 in Wales the health service received £481 million. At 1991 prices that is £1,113 million. We are spending £1,769 million, so we are funding at record levels.

Mr. Livsey: Does the Secretary of State realise that wards in psychiatric hospitals are still being closed despite the fact that there are inadequate facilities for community care and that the Mid Wales hospital in my constituency, at Talgarth, is the subject of a feasibility study? Will the Minister give us an assurance that no psychiatric patient will be discharged into the community without proper facilities being made available?

Mr. Hunt: I am happy to give that assurance. I thought that all-party support had been given to the policy of moving people into the community, with the requisite support services. We in Wales should take pride in the fact that, although admittedly we are not so far forward as many of us would like to be, we have made considerable progress under the mental handicap strategy.

Mr. Barry Jones: Will the right hon. Gentleman confirm that Pembroke health authority was given £50,000 by the Welsh Office to pay for its application for NHS status? Will he rule out, here and now, any further such bribes to get NHS hospitals to opt out of local health authority control? The people of Wales reject the handling of our health service by the Under-Secretary of State and they do not support the Secretary of State's policies on our health service.

Mr. Hunt: The answer to the first point is yes. The answer to the second point is that it was not a bribe—it was finance to fund the preparation of the first application for NHS trust status in Wales. I make it clear that neither I nor my hon. Friend the Under-Secretary of State will entertain applications for NHS trust status unless we are convinced, first, that the hopital concerned will stay within the NHS, secondly, that it will be financially viable and, thirdly, that the change will result in better patient care. I can put that across clearly to the hon. Gentleman.
We are still being criticised on NHS funding. Let me put it in simpler terms. When we came into power in 1979, the health service was spending £171 for every man, woman and child in Wales. That was not a bribe—that was the level of spending that the Labour Government had reached. Uprated to 1991 prices, it would be £396. We are spending £614 for every man, woman and child.

Urban Renewal (Holyhead)

Dr. Marek: To ask the Secretary of State for Wales, pursuant to his answer to the hon. Member for Caernarfon (Mr. Wigley) of 10 June, Official Report, column 456, what action he has taken in connection with rail services under his responsibilities for initiatives for urban renewal in Holyhead.

Sir Wyn Roberts: The provision of rail services in Holyhead is the responsibility of British Rail. I have granted supplementary credit approvals of £250,000 to Gwynedd county council in the current financial year to fund the high-speed train refuelling facilities at Holyhead.

Dr. Marek: What else does the Minister intend to do to ensure that Holyhead retains its position as the centre for freight travelling to and from the Republic of Ireland, especially in view of British Rail's stupid decision to use the route from Liverpool to Belfast and then transfer freight by lorry to Dublin? Also, what does the Minister intend to do to reinstate the InterCity service between north Wales and Euston? The 9 pm train from Holyhead was withdrawn a few weeks ago by British Rail, and between 100 and 150 people had to stand all the way to Crewe, packed into a four-car sprinter unit.

Sir Wyn Roberts: On the last point, I am sure that British Rail will be glad to hear of the heavy demand for its services. The hon. Gentleman knows that there has been an increase in the number of services available to take people, if not to Euston from north Wales, to Manchester and Crewe where they can take connecting trains for London. As for freight, we must make the services from Holyhead more competitive. The more I study the question, the more I realise that we lose freight traffic because we are not so competitive as we should be.

Oral Answers to Questions — CHURCH COMMISSIONERS

Clergy Stipends

Mr. Ian Taylor: To ask the right hon. Member for Selby, representing the Church Commissioners, what recent consideration the Church Commissioners have given to the current stipend of a vicar.

Mr. Michael Alison (Second Church Estates Commissioner, representing the Church Commissioners): The Commissioners, as the central stipends authority, review stipends regularly and will consider them again at a conference with dioceses in November, and at the annual stipends conferences which take place each spring. The current average stipend of an incumbent is about £12,100 per year. In addition, he receives some benefits in kind, including free accommodation and a non-contributory pension, the average value of which is estimated by the Commissioners to be £7,260.

Mr. Taylor: Will my right hon. Friend carefully consider taking £1 off a vicar's stipend every time that vicar uses the new Prayer Book which has been published by one of the oldest publishing houses in the country and in which the Lord's Prayer refers to God as "Our Mother and Father"? Is it not sensible that curates who are themselves confused about bisexuality should not try to confuse their congregations about whether Jesus was a hermaphrodite?

Mr. Alison: My hon. Friend makes a serious point, albeit in a light-hearted style. The liturgy of the Church of England is approved by Parliament and therefore has a statutory basis. It would be unlawful to make any unauthorised liturgical change of gender in the Lord's prayer or in any other authorised liturgical service. In that respect, the restraint of the law is even more potent than pay restraint. My hon. Friend refers to the identity of Jesus. He will know from the Gospel that His most popular self-designation was "Son of Man", which is a double positive—or a double negative, depending which way one looks at it.

Church Urban Fund

Ms. Hoey: To ask the right hon. Member for Selby, representing the Church Commissioners, whether the Church Commissioners have reconsidered their contributions to the church urban fund for 1991.

Mr. Alison: The Commissioners board of governors will review the position with regard to a grant for the church urban fund towards the end of this year.

Ms. Hoey: Will the right hon. Gentleman convey to the board of the Church Commissioners the concern that will be felt in inner city areas if the grant of £1 million given in the past four years is not fully restored? It will be seen as a downgrading of the great work that the Church has done in the poorest areas in the inner cities and among the disadvantaged. I ask the right hon. Gentleman to remind the Church Commissioners of the words of the Archbishop of Canterbury who said last week of the church urban fund:
It brings hope where none seemed possible.
Will the right hon. Gentleman convey those thoughts to the governors?

Mr. Alison: I take careful note of what the hon. Lady has said and I will certainly convey to the Church Commissioners her views about the need to return to the £1 million grant. However, she will bear two points in mind. The church urban fund this year will, from its own resources, be able to maintain the level of its grants even in default of the Church Commissioners' £1 million, because it already has a substantial income. The money that we would otherwise give to the church urban fund this year will go to clergy stipends, and will especially be slanted and directed towards the poorest inner city parishes. What the church urban fund loses, the poorer parishes get through the maintenance of their stipends.

Clergy Stipends

Mr.Bowis: To ask the right hon. Member for Selby, representing the Church Commissioners, what provision is made for public consultation over clergy stipends.

Mr. Alison: The Commissioners, as central stipends authority, consult dioceses at least once a year about future stipend levels and take account of their views when making recommendations. A report is submitted annually to the General Synod which may debate the report if it chooses.

Mr. Bowis: Does my right hon. Friend agree that there is considerable public concern that for many family men


the level of stipend is inadequate? At the same time, many people share the view of the noble prelate the Archbishop of Canterbury that perhaps there should not be total security of tenure in parishes. Will my right hon. Friend encourage widespread consultation to see whether there cannot be a new system of payment of stipends to take on board those two points, perhaps by using some form of incentive payments?

Mr. Alison: I take careful note of what my hon. Friend has suggested. The notion of productivity in the cure of souls is difficult to administer fully, humanely and consistently. He will have noticed the level of stipends and the supplementary payments that are available, thanks to the Church Commissioners' successful administration of their funds in recent years. There has been a 75 per cent. increase in the level of stipends in real terms, greatly outpacing the rate of inflation. There is more land to be possessed and more to be done. We will do our best to follow through my hon. Friend's suggestion.

Oral Answers to Questions — HOUSE OF COMMONS COMMISSION

Toilet and Changing Room Facilities

Mr. Janner: To ask the hon. Member for Berwick-upon-Tweed, representing the House of Commons Commission, what steps the new Director of Works will take to improve staff toilet and changing room facilities.

Mr. A. J. Beith (on behalf of the House of Commons Commission): The Director of Works, who is a member of the department of the Serjeant at Arms, took up his post in July, but he will not become directly responsible for the parliamentary works programme until it is transferred to the Commission from the Department of the Environment next April. In the meantime, I will ensure that any concerns that the hon. and learned Gentleman has are made known to the relevant authorities.

Mr. Janner: Does the hon. Gentleman agree that many of the facilities for staff members in this Palace are wholly unworthy and in many cases disgusting? Is he aware, for example, that the waiting staff changing rooms have been moved to the former office of the right hon. Member for Yeovil (Mr. Ashdown), the leader of his party, who I understand has moved out? None the less, there is no security and nowhere for the staff to lock away their clothes. They are not even allowed to have keys to the door. Will the hon. Gentleman look into the matter and try to arrange for our staff to have the facilities to which they would be entitled anywhere else?

Mr. Beith: The Commission is well aware of the need. New changing and rest facilities have been made available at No. 1 Parliament street, where those criticisms will not apply. I will look at the specific points raised by the hon. and learned Gentleman and ensure that they are brought to the attention of the appropriate authorities.

Mr. Dickens: Does the hon. Gentleman feel that if the toilet facilities in the House of Commons are sufficient for the hundreds of people who visit the House of Commons each day, they should by the same token be sufficient for the staff who work in the building?

Mr. Beith: Those matters do not fall within the responsibility of the Commission until the transfer of the works next April. It will be our intention that there should be adequate and excellent facilities for staff members and visitors.

Refreshment Department

Mr. Skinner: To ask the hon. Member for Berwick-upon-Tweed, representing the House of Commons Commission, what recent reviews have been undertaken of the payments and conditions of service of staff of the Refreshment Department; and if he will make a statement.

Mr. Beith: Pay reviews for the non-industrial and industrial staff of the Department took place on 1 April and 1 July respectively, and pay increases for both groups of staff have been implemented recently in line with civil service pay agreements. The Establishments Office of the House has reached the final stage of negotiations with the relevant unions on the introduction of a simplified grading and pay structure for non-industrial grades, which will affect a small percentage of Refreshment Department staff. In addition, consultations have proceeded along similar lines for the industrial grades. The Commission has recently agreed proposals put forward by the Board of Management, and has authorised the Establishments Office to commence negotiations with the Hotel and Catering Union.

Mr. Skinner: Does the hon. Gentleman accept that when the £3·40 barrier was broken for the hourly rate paid to House of Commons refreshment staff, no one was sacked and, incredibly, more staff have been employed since then? Will those staff be treated in the same way as Members of Parliament when the next review is carried out? Will they be awarded pay rises of no less than 6·5 per cent., and when their pensions are calculated, will the Commission ensure that those pensions are in line with the recommendations of the Top Salaries Review Body, which is so embarrassed about the 60 per cent. pension increase awarded to some top civil servants that it has postponed the increase until after the general election? Will the hon. Gentleman guarantee that staff will receive the same increase, and that they will receive it before the election?

Mr. Beith: It is quite some time since the House broke through the £3·40 barrier to which the hon. Gentleman referred. As for pensions, staff—unlike Members—receive non-contributory pensions, along with a series of other benefits, which makes it difficult to compare their terms with those operating outside the House. A package containing a number of improvements is, however, currently the subject of negotiation.

Mr. Charles Wardle: Bearing in mind the number of people who work in the Refreshment Department and elsewhere in the Palace of Westminster, and the number of visiting officials from Government Departments—not to mention the number of right hon. and hon. Members— what can the hon. Gentleman do to promote the idea of establishing a mini-supermarket on the premises? Given the hours worked by all employees in the Palace, it is sometimes very difficult for them to find their way to a shop to buy essential supplies.

Mr. Beith: The hon. Gentleman's interesting suggestion does not arise out of this question.

Disabled Employees

Mr. Corbyn: To ask the hon. Member for Berwick-upon-Tweed, representing the House of Commons Commission, how many people employed by the Commission are registered disabled; and what proprtion this is of total employees.

Mr. Beith: Of the total number of staff employed by the House of Commons, eight—that is, 0·7 per cent. of the total—are registered as disabled. The Commission's policy with regard to the employment of disabled persons is set out in its annual report of 1981–82, and—together with a summary of the positive action taken by management to increase the recruitment of disabled staff—was printed in the answer given on 13 June 1991 to a written question to me from the hon. Member for Paisley, South (Mr. McMaster).

Mr. Corbyn: Is that not a most unsatisfactory reply, and is not the situation disgraceful? Legislation suggests that a minimum of 3 per cent. registered disabled should be employed. There is no reason on earth why, having passed that legislation, the House cannot implement it.
The hon. Gentleman has said that a statement about a positive action programme was made in 1981–82. That was 10 years ago, and an amazing total of eight people with disabilities are now working in the building. That is a disgrace. I urge the Commission to consider this as a matter of urgency, and to increase the number of vacancies for people with disabilities, providing a model for the rest of the country and demonstrating that we do not believe that those who suffer from disabilities are unable to work gainfully.

Mr. Beith: The numbers that I gave did not include all who work in the building: the staff of the Property Srvices Agency were not part of the staff of the Commission.
The authorities have taken positive action beyond the 1981 statement to ensure that disabled persons are aware that applications from them would be welcome. Measures include a statement to that effect in all advertisements, encouraging disabled people to state whether they are registered; keeping close links with the disablement resettlement officers, and organisations representing disabled people, to which all job vacancies are sent; and facilitating the placement of disabled students for work experience. Disabled applicants will normally be shortlist-ed for interview if they are appropriately qualified. We are anxious to improve the figure as, I know, are many other employers.

Oral Answers to Questions — HOUSE OF COMMONS

Annunciator System

Mr. Butler: To ask the Lord President of the Council if he intends to upgrade the annunciator system.

The Lord President of the Council and Leader of the House of Commons (Mr. John MacGregor): There are as yet no firm proposals to upgrade the annunciator system, but the first step has been taken. During the summer

recess, a consultant has been investigating the require-ments for a cable network covering the entire Palace, which would provide hon. Members with information technology facilities but could also carry a modernised annunciator system. His report is expected to be presented before the end of the year.

Mr. Butler: Is not the technology for the annunciator system nearly a quarter of a century old? When we have a new system, will it be able to take an audio feed from the Chamber?

Mr. MacGregor: I believe that it is nearly a quarter of a century old. However, it was decided a little while ago that as the system was still working satisfactorily it did not make sense to change it outside the context of an examination of a cable network for the House as a whole. We have therefore taken the first steps in that regard, and the House will recall that the matter was debated in July 1991. Shortly after that debate, the House of Commons Commission gave the necessary approval for the consultancy study. That is now proceeding and we shall progress to the next stage after that.

Dr. Cunningham: May I strongly support the reply of the Leader of the House to the hon. Member for Warrington, South (Mr. Butler)? We should not waste money on an outdated annunciator system when we need to recable the House so that hon. Members can have access to information systems, data bases and as many television channels as we decide appropriate. I hope that we would decide that it was appropriate to have the live feed from the House as well.

Mr. MacGregor: The hon. Gentleman knows that I agree with him about how we should proceed on that matter. He will be aware that after the consultancy study the next stage is to set up a specialist working party to draw up the specifications for the interfaces required to produce a list of approved computers. The other matters can also be considered.

Televising the House

Mr. Tony Banks: To ask the Lord President of the Council how many complaints he has received from members of the public and hon. Members regarding the televising of the House.

Mr. MacGregor: I have received a few letters from members of the public making general comments, but I am not aware of any complaints about the way in which the televising operation itself has been carried out within the House during the current Session.

Mr. Banks: Televising the House of Commons is one bit of television output about which the Prime Minister does not have to write a letter of cringing apology to someone because it has, of course, been so successful. Following what the right hon. Gentleman said in reply to the previous question, when shall we have television from gavel to gavel so that people can tune in to the debates that they want to watch rather than the debates chosen for them by broadcasting journalists?

Mr. MacGregor: I agree with the hon. Gentleman that my right hon. Friend the Prime Minister has been extremely successful in the House in the way that he comes over on television. The hon. Member for Newham,


North-West (Mr. Banks) will be aware that the Select Committee on Broadcasting, &c. hoped that a continuous service operated by United Artists would be available from this autumn. There have been technical and legal problems with the Marco Polo satellite, but it is hoped that live continuous coverage of the proceedings of the House will be available from the Marco Polo satellite to cable subscribers in the new year as soon as the problems have been overcome.

Mr. Simon Coombs: I support what hon. Members have said about the need for live television coverage to be provided in the offices of hon. Members. When does my right hon. Friend expect the consultant's report to be available to him and, in due course, to the House?

Mr. MacGregor: We hope that the consultant's report to which I referred earlier will be available towards the end of the year—probably by the end of November.

Building Work

Mr. Janner: To ask the Lord President of the Council if he will make a statement on the forthcoming transfer of responsibility for building work in the Palace of Westminster.

Mr. MacGregor: Following the appointment of the Director of Works in July, good progress is being made to set up the new organisation which will assume responsibility for works services.

Mr. Janner: Will the Lord President of the Council be kind enough to arrange for a survey and census of the hazards in this building to elderly and infirm people who use the House? Meanwhile, will he use his powers at least to conjure up some railings for the stairs leading down from Westminster Hall to the interview rooms, down which to the right hon. Gentleman's knowledge an elderly, charming and kindly peer recently fell and was very lucky not to be severely injured?

Mr. MacGregor: I will certainly arrange for that particular matter to be looked into. The hon. and learned Gentleman is aware that we are about to undertake a major study with regard to access for the disabled, and that will include some of the points to which he referred.

Office Allowance

Mr. Hind: To ask the Lord President of the Council if he will make a statement on his plans to review the parliamentary office allowance.

Mr. MacGregor: As I announced in a written answer on 25 July 1991, I wrote to Sir David Nickson, chairman of the Top Salaries Review Body, on 24 July, asking him to conduct a review of the office costs allowance. Sir David has since replied, agreeing to produce a report by the middle of February.

Mr. Hind: My right hon. Friend will be aware that many hon. Members feel that they are short-changing their constituents because of their lack of resources, particularly in dealing with the large number of letters and constituency problems that they receive. Will my right hon. Friend put his weight behind the inquiry to ensure

that more research facilities will be available by way of additional cash and help in dealing with the large number of matters that we are now asked to sort out?

Mr. MacGregor: I put my weight behind having the review undertaken so that all those matters could be looked at by the TSRB—including, of course, hon. Members' increased work load. My hon. Friend will know, however, that the TSRB wishes to conduct a comprehen-sive survey of hon. Members in relation to their use of staff, office costs and their views on the allowance, which would clearly include the points that my hon. Friend has raised. I am sure, therefore, that he will wish to make his views known to the TSRB.

Mr. Ian Bruce: Will the House authorities look carefully at the possibility of providing a special allowance for Members who like to keep their staff in their constituencies, in addition to the office costs allowance which is currently paid? That would have the double effect of paying for facilities in constituencies and taking pressure off accommodation in London, so we might solve two problems with one stone.

Mr. MacGregor: My hon. Friend may wish to put that point to the TSRB, together with his reasons for it. It would, of course, be for the TSRB to make recommendations.

Palace Tours

Mr. Simon Coombs: To ask the Lord President of the Council what is his estimate of the number of people who toured the Palace of Westminster last year; and if he will make a statement.

Mr. MacGregor: I am advised that in 1990 the estimated total number of visitors to the Palace of Westminster in Members' parties was 112,265. In addition, 6,720 schoolchildren took part in tours as part of the autumn visits programme organised by the education unit.

Mr. Coombs: Has my right hon. Friend had an opportunity to consider the point that I raised with him in the summer—that greater encouragement should be given to allowing people who are not connected with Members of Parliament to visit the Palace during the summer recess?

Mr. MacGregor: I indicated in my reply to my hon. Friend during the summer some of the difficulties involved, particularly those of a security nature, and the various hoops that would have to be gone through The position has not changed.

Mr. Cryer: Will the Leader of the House do something about a point of order that I raised before the summer recess? I refer to the provision of a room in which disabled visitors to the House can relax. When I took a party of blind students around the House, they were provided with absolutely no facilities at all. It is disgraceful that they cannot be taken anywhere for a cup of tea, they cannot be allowed to sit down anywhere, and there is no room for them. Groups of blind students have to be pushed to one side to allow rich pickings from the corporate entertainment in private dining rooms. It is about time that practice stopped and proper facilities were provided.

Mr. MacGregor: The whole House will be aware of the pressure on accommodation in the Palace. The hon.
Gentleman's point is for the successor to the Accommodation and Administration Sub-Committee to consider if he would like to put it to it.

Terrace Marquee

Mr. Harry Greenway: To ask the Lord President of the Council if he has any plans to seek to retain the marquee on the terrace all the year round; and if he will make a statement.

Mr. MacGregor: There are no plans at present to keep the terrace pavilion in operation for the whole year. Any permanent construction would need planning permission from Westminster city council and the approval of the Royal Fine Art Commission and English Heritage. It is unlikely that the terrace pavilion, while appropriate for its present use, would be considered a suitable permanent structure.

Mr. Greenway: Does my right hon. Friend accept that, even if planning permission would be hard to come by, the

terrace pavilion is a useful facility he should explore ways in which it can be maintained all the year round in view of its popularity and the demand for it?

Mr. MacGregor: My hon. Friend is certainly right about the demand for it. The facilities have been well received and have been heavily booked by hon. Members. Having the pavilion all the year round, which was examined by the Service Committee in the past, would involve problems at times of year when it is not currently used. I refer to problems of wear and tear, and possibly even loss of the whole facility. Maintenance and refurbishment would have to be done on site, too, and it is felt that that is more effectively done elsewhere. However, it is a matter that the Services Committee, or its successor under the Ibbs proposals, could bear in mind.

Mr. Dick Douglas: On a point of order, Mr. Speaker.

Mr. Speaker: I will take the statement first.

Social Security Benefits (Uprating)

The Secretary of State for Social Security (Mr. Tony Newton): With permission, Mr. Speaker, I wish to make a statement about the uprating of social security benefits. This will take place for most benefits, as is now the normal practice, in the first full week of the tax year—that is, the week beginning 6 April. The statutory instruments to implement my proposals, applying to both Great Britain and Northern Ireland, will in due course be laid before both Houses for debate and a full schedule of the new benefit rules is being placed in the Vote Office.
I will, as usual, deal first with the main national insurance benefits, including in particular the retirement pension which now goes to some 10 million people. The bases for the uprating will be the latest available information about the increase in the retail prices index over the past year: that is to say, the rise of 4·1 per cent. in the 12 months to September.
Our firm and continuing commitment is to increase the pension fully in line with prices. Next April, therefore, the basic pension will go up by £2·15 a week for a single person, from £52·00 to £54·15, and by £3·45 a week for a couple, from £83·25 to £86·70. This will increase expenditure on retirement pensions by around £1 billion.
Public service pensions will also be increased across the board by 4·1 per cent. as will war widows' pensions and war disablement pensions. I am glad to be able to tell the House on behalf of my right hon. Friend the Secretary of State for Defence that the special Ministry of Defence payment to the pre-1973 war widows will similarly go up from £44·36 to £46·18 a week. This special payment will, of course, remain tax-free and continue to be disregarded in calculating entitlement to income-related benefits.
All other national insurance benefits will be increased by 4·1 per cent. taking unemployment benefit, for example, for a single person from £41·40 to £43·10 and from £66·95 to £69·70 for a couple. Maternity allowance and lower rate statutory maternity pay, both of which were increased in real terms in the last uprating, will be increased from £40·60 to £42·25 and from £44·50 to £46·30 respectively.
National insurance sickness benefit will go from £39·60 to £41·20 for a single person and from £64·10 to £66·70 for a couple. As the House knows, however, most short-term sickness is now covered by statutory sick pay administered by employers, in which a number of changes were made last year. The new arrangements, including the special provisions for small employers, appear to be working well and I do not propose to disturb them except to increase the lower rate of SSP, which goes to employees currently earning between £52 and £185 per week. This will be increased by the retail prices index, from £43·50 to £45·30. The higher rate, which goes to the better-paid employees, of whom the great majority are in any case covered by occupational sick pay schemes, will remain at £52·50, since I judge that the cash required to increase it can more sensibly be used to improve the position of sick and disabled people in other ways.
I turn next to the income-related benefits—income support, housing benefit and community charge benefit. By convention, since the main housing costs of income support claimants are met separately and directly, these benefits have been uprated by an index which seeks to exclude such housing costs.
As the House is aware, since these benefits were uprated last year, there has been a £140 reduction in the community charge, which in turn has meant a reduction of £28—over 50p a week—in the amount which those on income support are expected to meet from what was included in their benefit for that purpose. There is therefore a strong case for adjusting benefit rates accordingly to produce an expenditure saving of £200 million. I do not propose to do that.
I have, however, concluded that it would be right in these circumstances to align the calculation of what is called the Rossi index more exactly than at present with the items the costs of which people are expected to meet from their benefit. This entails including within it not only 20 per cent. of community charge, but certain miscellaneous housing costs, and water rates, which have not previously been covered in the calculation. This will put the index on a more logical basis for the future— indeed, the inclusion of water rates also responds directly to a number of representations that we have received from welfare rights bodies and others.
The result is to produce an uprating index of 7 per cent., nearly 3 percentage points higher than the full RPI. Other things being equal, that would entail a small reduction in the cost of the uprating, by comparison with the use of the previous less comprehensive calculation. But that will not in fact happen, because I propose to devote rather more than the sum involved to an additional increase in the income support premiums for pensioners who are disabled or who are over 80. Those premiums will be increased, over and above the 7 per cent., by £1 a week for a single pensioner and £1·50 for a couple, contributing to overall increases in income support for this group of £5·10 a week, from £58·10 to £63·20 for a single person, and of £7·70 a week, from £88·45 to £96·15 for a couple. The cost will he £60 million.
Nearly 600,000 pensioners will gain to the full extent through income support, and over 400,000 will gain through increases in housing benefit and community charge benefit. It will thus build further on the series of measures that we have taken in recent years to give extra help to the less well-off pensioners and especially those who are older which have already increased the pensioner premiums by some £300 million in real terms in the past two years.
All other income support rates will go up by 7 per cent. Thus, benefit for a single person over 25 will increase from £39·65 to £42·45; for a couple with two children aged 10 and 12 from £104·55 to £111·85; and for a pensioner couple aged under 74 from £83·15 to £88·95.
Before leaving the income-related benefits, there are three further issues to which I should refer. The first are called the non-dependant deductions in housing benefit and income support for housing costs—that is to say, the contribution expected from the income of a non-dependant, living in the household of a claimant, in calculating the householders' benefit. Here I have received representations that these deductions, however reasonable in concept, are at too high a level for those on lower incomes. I shall therefore shortly be consulting the Social Security Advisory Committee and the local authority associations on a proposed restructuring of the deductions from next April.
Its effect would be to reduce the contribution expected from anyone whose income is below £130 a week— including a reduction of over a quarter, from £5·70 to £4,


in that applying to a non-dependant who is not in full-time work or whose income is below £65—but to expect a somewhat larger contribution than at present, £18 instead of £13·50, from those in full-time work with incomes over £130 a week. While giving what I believe will be widely seen as a fairer and more sensible structure and once again helping the least well-off, these proposals would reduce benefit expenditure by about £50 million.
This, however, helps me to make much more substantial increases than would otherwise have been possible in the second area on which I need to touch—the income support limits for residential care and nursing homes. Unlike other income support rates, these include provision for housing costs. But I intend to make increases significantly greater than inflation, raising support in this field by nearly £200 million, or some £80 million more than would come from simply uprating the limits in line with the retail prices index.
After the very large increases made last year in the limits for nursing homes, I have concluded in the light of the available evidence and the representations made to me that the right course is a general increase in virtually all the limits of £15 a week, thus giving a proportionately larger increase this year to people in residential care homes. For the residential care limits in two categories—those for the very dependent elderly and for the mentally handicapped, who between them cover almost 40 per cent. of all residential care home cases—I propose an increase of £20.
In only one case do I propose an increase below £15, which is in respect of the limit sometimes known as the terminal illness limit for nursing homes. Originally intended primarily to give additional help to hospices, it has not proved very effective for that purpose, since many hospices do not make charges and there is therefore no basis on which their patients can claim the special rates of income support. As a basis for distinguishing between nursing homes, it has become increasingly artificial and difficult to operate. I therefore think it right to make only a £5 increase in this limit, thus narrowing the gap between it and other nursing home limits, and to steer additional help to hospices in two other ways.
One is to make changes in the rules for attendance allowance and from next April also the new disability living allowance, which will give more than £2 million of additional benefit to people in voluntary hospices. The other is to make available from the social security budget a further £1 million towards the direct funding of hospices as part of the Government's commitment to increase their contribution to the movement. This sum will be made available through the Department of Health. I believe that these moves will be widely welcomed.
With that one exception to which I have referred, all limits will increase by more than 5 per cent., with the limit for the very dependent elderly in residential care homes going up by about 10 per cent.—making a total increase in this very important category, covering about a third of all elderly people in residential care homes, of 32 per cent. in three years. The Greater London additions for both residential and nursing homes will also be increased to £25 and £35 a week respectively.
Finally in relation to the income-related benefits, I should tell the House that the additional resources for the social fund which my right hon. Friend the Minister of

State announced in August, increasing this year's grants budget by some £10 million and the loans budget by some £30 million, will be fully carried through into provision for 1992–93, when the budget for the two elements together will be almost £300 million—30 per cent. higher than the budget initially made available in 1991–92. That is, of course, in addition to the greatly improved arrangements for cold weather payments, which are outside the budget and which, should the need arise, will be made automatically. Some 400,000 more people than previously would be eligible for payments.
I turn now to families with children. As I said in my statement this time last year, child benefit is and will remain a strong element in our policies for family support. That has been underlined by the further increase which has taken place this month, announced by my right hon. Friend the Chancellor of the Exchequer in his Budget, together with the undertaking that the benefit would in future be increased in line with prices.
After having reviewed the benefit levels in accordance with my statutory duty, I have decided that the right course for next April is to increase each of the rates which have just come into payment by the full 4·1 per cent. RPI increase for the whole year to September, even though they will have been at their present level for only six months. This will raise the payment for the eldest eligible child by 40p to£9·65 and the rate for other children by 30p to £7·80. One-parent benefit will also rise, by 25p to £5·85 per week.
At the same time, we shall continue with our policies to give greater help to low-income families with children, including not least those in work whose earnings are modest. That too, has been underlined by the increases in income support and family credit made in parallel with this month's child benefit increase. The relevant benefit rates, including the family premium and the age-related amounts for children, will all be increased in April by 7 per cent.
On the latest figures, family credit is now going to a record 356,000 families, 30,000 more than a year earlier, at an average level of more than £30 a week. That gathering success will be further reinforced next April by reducing from 24 to 16 the number of hours of work needed to qualify, which we expect to enable another 30,000 families to benefit immediately and a further 35,000 in due course. I shall shortly be consulting the Social Security Advisory Committee on proposals designed to ensure a smooth transition to those new arrangements and more generally to improve the speed and accuracy with which claims are processed.
While those changes will help families of all kinds, they are likely to be of particular help to lone parents who wish to work, who already account for more than one third of those helped by family credit. We have already improved the earnings disregard in housing benefit and community charge benefit. The introduction of the £15 maintenance disregard in those benefits next April will mean that lone parents receiving maintenance will still be better off in work on family credit with earnings up to £50 below what they would need at present.
The changes in family credit, together with the new maintenance disregard, will increase expenditure next year by some £70 million. That will mean that since 1988 we have made available some £600 million extra in real terms through the income-related benefits to improving the position of less well-off families with children.
I come now to benefits for sick and disabled people, to whose needs we have consistently sought to give special attention both in promoting and improving existing benefits and in developing new ones.
All the main disability benefits will go up by the 4·1 per cent. increase in the RPI, thus raising invalidity benefit in line with the retirement pension, and both severe disablement allowance and invalid care allowance from £31·25 to £32·55. The invalidity allowances payable with invalidity benefit, and since December 1990 the similar additions payable with severe disablement allowance, will also be appropriately increased.
The main disability premiums in income support, including the greatly enhanced premium for disabled children introduced 18 months ago, will, of course, rise by 7 per cent., so that, for example, the benefit for a family with a disabled child of 12 will increase from £107·60 to £115·10 a week.
Apart from the strategic improvements in benefits for disabled people, to which I will come in a moment, I have a number of detailed changes to make which will be of significant benefit to those affected. The residence qualifications for severe disablement allowance wall be brought into line with those for comparable benefits, making it easier for people coming or returning to this country to qualify. Families with children under 16 who receive social security help with care costs will, when the child has to go into hospital, keep that help for up to 12 weeks instead of four. The earnings limit for invalid care allowance will be further increased from £30 to £40.
A number of possibilities for simplification of the war pensions scheme are currently under discussion with representative bodies, in a joint effort to improve the working of the scheme. While I do not intend to make decisions on most of the issues involved until those discussions have been concluded, I have decided to add the war pensioners dependency allowance into the basic war pension for all disablement pensioners, which is not only a helpful simplification, but will give small gains to some 50,000 people. This group of small improvements involves a total additional cost of about £4·5 million.
I am also able to inform the House of our plans for further substantial increases in resources for the independent living fund, which is providing assistance to more than 10,000 severely disabled people. The provision for next year will rise by some 40 per cent. adding more than £20 million to this year's level of £54 million. That will ensure that the fund continues to play an important role in helping people with disabilities to live independent-ly in the community in the run-up to the full implementation of community care.
Although not strictly an uprating matter, I should also take this opportunity to tell the House, following consultation with the Social Security Advisory Committee, that I am today laying revised regulations to re-establish the original policy intention underlying the income support severe disability premium, whose purpose is to give extra help to severely disabled people living independently of their families, but which has, in some cases, been extended well beyond that by the creation of artificial tenancy arrangements within one household. While accepting that the regulation re-establishes the clear policy intention when the premium was introduced., the committee has asked that steps should be taken to ensure that no disabled person should lose an already established entitlement. I gladly accept that. In those cases,

appropriate protection will he provided at an additional cost of £5 million, compared with the proposal originally referred to the committee.
From next April, mobility allowance and attendance allowance for those under 65 will be replaced by the new single extra costs benefit—disability living allowance, or DLA. Those entitled to them will be automatically transferred to the new benefit and the relevant rates will be set at 4·1 per cent. above those of the existing allowances. Thus the higher mobility component of DLA will be £30·30—£1·20 above the current mobility allowance—and the two upper rates of the care component will be set at £43·35 and £28·95, £1·70 and £1·15 a week respectively above the current attendance allowance rates. Attendance allowance itself will be similarly increased for those over 65, for whom it continues.
At the same time, two new tiers of DLA will be introduced, giving help with care or mobility costs—or both—for the first time to some 300,000 people for whom the existing benefits do not cater. Among the gainers will be 10,000 severely mentally handicapped people with serious behavioural problems, who cannot at present get help with their mobility costs and who will qualify for the top rate of the mobility component.
The new lower rates of disability living allowance will be set not at the £10 a week on which discussion of the new structure was based, but at £11·55, which in effect applies this year's and last year's uprating to the original figure. For those on the lowest incomes, receipt of even one of the lower rates of DLA will bring entitlement to the disability premium in the income-related benefits. Thus, those on income support will be nearly £30 a week better off.
In April, we shall also introduce the new disability working allowance, helping up to 50,000 disabled people who wish to work but have limited earning capacity, by enabling them to top up those earnings with benefit. The rates governing its assessment are set out in the schedule to my statement. They will mean, for example, that a single person could earn as much as nearly £100 a week, while still being entitled to some disability working allowance, and with it the disability premium in housing and community charge benefit, together with the reassurance which disabled people have been seeking of a much extended linking period back to their old incapacity benefit, should they be unable to continue working.
The new disability benefits mark a further important stage in a programme which, in the past two years, has already included real increases in the disability premiums both for adults and children, the introduction of a carer's premium and of additional payments with severe disablement allowance, the extension of mobility allowance to the deaf-blind, and the extension of attendance allowance to severely disabled babies and the terminally ill.
Overall, by 1993–94, the better part of 1 million disabled people will be gaining from this programme, either through real increases in existing benefits or entitlement to new ones, to a total of some £300 million. With earlier changes and the massive expansion that has taken place in the coverage of mobility allowance, attendance allowance and invalid care allowance, it will mean that, next year, expenditure on benefits for disabled people and carers will be no less than two and a half times greater than in 1979.
Despite the difficult circumstances, we have been able to commit ourselves to the uprating that I have outlined today, at a cost of over £3 billion. We have honoured and


confirmed our pledge to retirement pensioners. We are doing more for those who are older and least well-off, more for families with children, and more for disabled people. Those are our priorities, and I believe that they will be widely endorsed.

Mr. Michael Meacher: Is the right hon. Gentleman aware that pensioners will be bitterly disappointed by the statement? Not only is £2 a week a miserly increase but, contrary to the Government's promise, the increase does not protect pensioners against inflation. Is he aware that the RPI has fallen to 4·1 per cent. largely because of the cuts in mortgage rates, but as almost no pensioners have mortgages, the relevant inflation index for pensioners is the underlying rate excluding mortgages, which is 5·7 per cent.? Is he aware that his announcement today short-changes pensioners by nearly £1 a week? Is not, £2 a week increase for pensioners an insult? It is not even enough for a pound of sausages and a couple of loaves, while workers on average pay are receiving increases of more than £20 a week and some executives, increases of more than £2,000 a week.
The Prime Minister talks of a society with the power to choose. By giving pensioners an increase of £2 a week, is he not giving them the obligation to go without? If the Chancellor can afford to spend nearly £2 billion by cutting income tax by a further 1p in the Budget, as he keeps hinting, is it not time that pensioners were given priority —as Labour now proposes, with £5 and £8 a week increases, and the restoration of the pension link with earnings—instead of having to be at the end of the queue, as they always are under this Government?
Will the right hon. Gentleman admit that, if the Government had not broken Labour's pension link with earnings, thereby cutting pensioners out of rising living standards for the past 11 years, he would be announcing —[Interruption.] Conservative Members may try to shout me down, but they will not stop pensioners learning the truth about this statement.
If the Government had not broken the link 11 years ago, would not the right hon. Gentleman now be announcing a single pension of £70 a week instead of £54, and one of £111 a week for a married couple, instead of £86? Will the right hon. Gentleman admit that he is saving £450 million this year alone at the expense of pensioners by refusing to uprate the pension in line with earnings—three times as much as the total pre-election sweetener for pensioners announced today?
The right hon. Gentleman claims that he is concentrating extra resources on the poorest. He is not. Will he confirm that the 7 per cent. increase for those on income support that he announced today is less than the rate of inflation for people whose housing costs are wholly met from other sources? Is he aware that the poorest pensioners of all are the 900,000 living below the income support level who will get only the 4·1 per cent. increase, which will not even keep up with the true rate of pensioner inflation?
We welcome the £15 a week increase in DSS payments to those in private residential homes, but has the right hon. Gentleman noticed that the latest survey by Price Waterhouse—the same company that the Government used a year ago—shows that the average shortfall in DSS payments is not £15 or £20 a week as he announced today,

but more than £60 a week? Will he confirm that the Government, having pushed nearly 200,000 frail, elderly residents who are on income support into private homes, are still nowhere near meeting the charge imposed by the homes, so both the residents and their families continue to face anxiety and the threat of eviction?
Does the right hon. Gentleman accept that the increase in child benefit that he has announced goes no way to restoring the cut in its real value in the three-year freeze since 1987? Will he confirm that the shortfall is still more than £2 a week per child for the second child and subsequent children; and that since this is the last uprating before the election, it means that only Labour will now make good the substantial cuts from these Tory years?
The most noteworthy aspect of this statement, despite its extreme length, is its omissions. Why did the right hon. Gentleman say nothing about the young homeless, deprived of all benefit by him and reported by many citizens advice bureaux to be starving? Or does he regard them, like Sir Bernard Ingham, as "a blot" on the domestic and tourist landscape; or like the Minister for Housing and Planning, who described them the other day as people you trip over on your way to the opera?

Mr. Robert G. Hughes: Disgraceful.

Mr. Meacher: It is indeed disgraceful—for once I can agree with the hon. Gentleman.
Will not the right hon. Gentleman create more young homeless by the £50 million increase in the non-dependent deductions that he has announced? Why has he said nothing about the unemployed, whose benefits have been cut by £1·5 billion a year since 1979 and whose unemployment benefit is as a result only one third of the level paid to unemployed people in France of Germany? If the right hon. Gentleman is really interested in assisting the poorest, why has he offered no new money for the social fund, applications to which, due to sharply rising unemployment, have risen fast recently, but refusals of which are rising even faster?
Why has the right. hon. Gentleman said nothing about ending the payment of 20 per cent. of the poll tax by the poorest in our society? Even today there was the announcement of an ingenious new way of funding the£140 reduction in the poll tax by cutting—

Mr. John Marshall: Nonsense.

Mr. Meacher: Perhaps the hon. Gentleman does not understand this, but it is being done by cutting the Rossi index for the very poorest.
After this statement, more than 10 million people will still be forced to try to cope at the new income support level of £42·50 a week, one seventh of the average wage. Does the right hon. Gentleman really believe that that is sufficient for one sixth of the population to feed, heat and clothe themselves for months and sometimes years on end? The Prime Minister is producing not a classless society but a "couldn't care less society", and this statement will confirm our status as the poverty capital of Europe.

Mr. Newton: The hon. Member for Oldham, West (Mr. Meacher) has been rather more restrained than usual when reacting to my statements, but I cannot honestly say that he has been more sensible. It is quite clear that we have put more resources into the social fund and that they are being fully carried through next year.
The hon. Gentleman's point about the young homeless in relation to non-dependant deductions is manifestly absurd because I made it plain that increased deductions were to be expected only from those earning more than £130 a week.
I have listened to the hon. Gentleman's endless attempts to make something out of child benefit, but I must remind him that we have put £600 million more into helping less well-off families, and expenditure on families with children is now higher than if, over the past three years, we had increased child benefit alone.
I do not know whether the hon. Gentleman has yet had a chance to look at the Price Waterhouse survey, but when he has examined it he will see that, taking regional variations into account, the report does not substantiate his suggestion that much more is needed than the new rates that I announced today.
What the hon. Gentleman says about pensioners would be rather more credible if he had said last year, when we made an increase of almost 11 per cent., much of which was associated with the rise in mortgage rates, that we had given a real increase to pensioners. As always, of course, the hon. Gentleman tries to have his cake and eat it. He should know that, if pensions had been uprated only in line with the pensioner price index, which seeks to measure pensioners' costs specifically, the increases over recent years would have been a great deal less than those that we have made in line with the retail prices index.
The hon. Gentleman asked me to confirm some figures, which no doubt he has carefully calculated, about what would have happened if we had pursued Labour's policies in respect of uprating. If we had pursued those policies, pensioners would now be a great deal worse off. We have already seen pensioners' incomes increasing generally far faster under this Government than under the previous Government. If the hon. Gentleman wants confirmation of the risks that pensioners would face if we went along with the inflationary tactics of the hon. Gentleman., he should look no further than to the activities of the shadow Chancellor and shadow Chief Secretary, who go round the country saying that the hon. Gentleman's promises in this area are not promises at all.

Mrs. Marion Roe: I congratulate my right hon. Friend on the excellent package of benefit increases, especially the increases in child benefit. Will he confirm that the full inflation uprating means that there will be three increases in child benefit within the space of a year?

Mr. Newton: Yes, I can confirm that, and I am pleased to have been able to announce this further increase which, as I said, uprates a six-month benefit rate by a full year's inflation.

Mr. Simon Hughes: Many things in the statement are welcome, especially the assistance for people in residential and nursing homes, for the over-80s, for families with children and for those who are mentally ill or in long-term categories of sickness or disability. The disappointments in the right hon. Gentleman's statement, and therefore the evidence of his failure to win the battle with the Treasury, relate to those on income support, who will still have to pay 20 per cent. of their poll tax, and pensioners. Although the Secretary of State rightly says that last year pensioners got more than the cost of living increase, this year they will receive

significantly less—about 3 per cent. less across the board —and in relation to basic pensions they will not have a guarantee of a full pension, irrespective of contribution for the country as a whole. The great failure is that pensioners are the victims of the statement.

Mr. Newton: I need hardly say that I do not share the hon. Gentleman's view; nor will many people when they have had the opportunity to study what I said in more detail. I have put another £60 million into real increases for the older, less well-off pensioners, about £70 million into helping less well-off families with children, and about £80 million above the RPI into the area of residential care and nursing homes. That will help rather more than 200,000 less well-off pensioners. The new levels of disability benefit, which will take benefit to people who do not get anything at all at the moment to help with costs, are worth £120 million. I do not regard that as defeat, and I do not think that other people will, either.

Mr. Andrew Bowden: Is my right hon. Friend aware that these increases will be widely welcomed throughout the country? Will he emphasise to the House that, under the policies of the last Labour Government, the savings of millions of pensioners were crucified by a 26 per cent. rate of inflation? If Labour returns to office, precisely the same thing will happen again. Will my right hon. Friend turn his attention to the residential care allowance, especially in the south-east? We have special problems because our expenses and costs are much higher than those in most other parts of the country.

Mr. Newton: I am grateful for the first part of my hon. Friend's question. I know that he takes a strong and continuing interest in this subject, which is a great credit to him. On his latter point, I cannot at this stage undertake to introduce yet another complicated regional arrange-ment into the residential care and nursing home limits. My hon. Friend will have noticed that I increased the Greater London allowance, although I realise that that does not quite meet the point that he was making, as I increased it for nursing homes last year. I hope, too, that he will not overlook the importance of the increase that I made for the dependent elderly—a 32 per cent. increase over three years —which will help about one third of those in residential care homes.

Mr. John Battle: Is the Minister aware that on 24 June this year, the European Council of Ministers agreed that VAT would be increased by up to 9 per cent. on fuels and some food items? Would that not, at a stroke, completely wipe out in the next financial year the increases for pensioners that he has announced today?

Mr. Newton: The hon. Gentleman will be aware that these matters are under discussion in another place and go well beyond what I am in a position to comment on in the House today. He will also know that increases in prices, of whatever kind, are faithfully reflected in the indexes that we use, and shall continue to use, to uprate social security benefits.

Mr. John Hannam: I congratulate my right hon. Friend on producing an extremely generous uprating of benefit in such difficult times. In particular, I welcome the £100 million extra for disabled people. He has


increased the independent living fund by 40 per cent. Will he ensure that that excellent source of funding for severely disabled people continues?

Mr. Newton: My hon. Friend knows better than anybody, given his strong interest in the interests of disabled people, what our commitments have been in respect of helping them to live independently. I, too, welcome the further increases in resources that I have been able to announce this afternoon, especially that in the independent living fund.

Mr. Dafydd Wigley: I welcome the changes in disability benefits as far as they go, but may I press the Minister on one aspect of the water charges element? As he will know, I welcome the involvement of this element in income support, and it is a move for which many of us have pressed. However, does he accept that the position of the single pensioner is invidious? For example, the one who saw me last week, with a water charge of £220 on a single-bedroomed house, will have an increase in her water charges of RPI plus X, which will erode her pension by 50p immediately. She will not be helped by the announcement that the Secretary of State made today, because she is not on income support. Therefore, will he consider extending what he is doing for income support to all pensioners?

Mr. Newton: The dispute over the index used for income support has been over the fact that, until my announcement this afternoon, it did not include water rates. It follows that water rates are included in the retail prices index, which has been used for uprating pensions generally.

Mr. Patrick Nicholls: Bearing in mind the promise that we heard today from the hon. Member for Oldham, West (Mr. Meacher) to restore an earnings link to retirement pensions, may I ask my right hon. Friend to take this opportunity to remind the House that, although the last Labour Government introduced an earnings link, they were so strapped for cash that they were unable to implement the proposal? Is it not bare-faced cheek for the hon. Member for Oldham, West to pretend that it would not be the same again?

Mr. Newton: I am grateful to my hon. Friend for reminding the House that the last Labour Government found a way of, in effect, leaving out six months' inflation so as to save what would probably now be about £1 billion, largely at the expense of pensioners.

Mr. Tom Clarke: Does not the Secretary of State feel at least embarrassed that he has confirmed in his statement, yet again, that the Government have refused to implement the community care sections of the National Health Service and Community Care Act 1990 for at least another three years? Does he realise that even the marginal improvments in benefit that he has announced for people in private residential homes should mean that we have arm's-length inspections to ensure that minimum standards prevail? Why is he prepared to accept the absence of value for money, of inspection and of any strategy for community care?

Mr. Newton: The hon. Gentleman, to whom I also pay tribute for the interest that he takes in such matters, knows

of the various steps being taken to introduce a more independent element into the registration of residential care homes through new arrangements within local authorities. He will also be aware of all the steps taken towards the introduction of what I believe will be improved community care arrangements in 1993. Some of what I have announced this afternoon will underpin them, but, more generally, the arrangements will help disabled people who may not be covered by community care in the sense in which the hon. Gentleman means it but who nevertheless need the assistance of the social security system.

Sir David Price: Is my right hon. Friend aware that those of us who take a particular interest in the cause of the severely disabled are pleased that he was able to do so much more for the independent living fund, on which some of us have been pressing him for a long time? In view of his obvious confidence in the independent living fund, what is its future?

Mr. Newton: I think that my hon. Friend knows that we have made it clear that we intend to make arrangements for those covered by the independent living fund when the transition to community care takes place in 1993, but that thereafter, in general, it would be appropriate for new cases to look to the overall new arrangements for community care at local level.

Mr. Max Madden: Is the Secretary of State aware that most people will regard a 4p in the pound increase for pensioners as extremely mean, his silence on increasing the Christmas bonus frozen at £10 since 1972 as extremely miserly and his failure in Cabinet to abolish the 20 per cent. contribution to the poll tax by pensioners as extremely disappointing? Does he accept that the only way in which British pensioners will cease to be the poorest in Europe is to restore a link with earnings so that pensions can be increased by whichever amount increases most? That is Labour's policy and it is the best hope for British pensioners.

Mr. Newton: As I have said several times, if we adopted the European pensions policy so often urged on us, the first result would be that 2 million married women would lose the pensions that they currently receive on their husband's contributions. Secondly, I have not for a long time heard anyone from the Opposition have enough nerve to refer to the Christmas bonus, which for two years they did not pay at all.

Mr. David Nicholson: In addition to my right hon. Friend's help for people in nursing and residential homes and for those in hospices—his help for the latter will be widely welcomed by those in the hospice movement in my constituency—is he aware that his effective and caring targeting of help on the poorer pensioners will be widely welcomed? It is in sharp contrast to the extravagant promises made by the Opposition, which would lead to people being either conned or clobbered, or probably both. Will, he, however, ensure that the self-employed have full access to family credit because, as he will be aware, there are some difficulties in that respect?

Mr. Newton: I said in my statement that we are considering various ways in which to improve further the administration as well as the coverage of family credit. I shall certainly bear in mind my hon. Friend's point. I


welcome his support for the additional measure that I was able to announce this afternoon for less well-off, older pensioners. That measure means that we have made a great deal of improvement, in one way or another, for less well-off pensioners for three years running.

Mr. Jeff Rooker: I support the comments made by the hon. Member for Eastleigh (Sir D. Price) about the independent living fund. Does.. the Secretary of State realise that his answer highlights the fact that there will he two classes of disabled people if and when he does what he proposes to the independent living fund? Some people will have the benefit protected and some will be pushed into the underfunded community care system. Surely it is only equitable to offer the massive benefits in new systems of helping people to stay independent to as wide a section of the community as possible. He must not run away from that.
May I ask the Secretary of State one more question so that we do not get confused? He said specifically that the figure given by my hon. Friend the Member for Oldham, West (Mr. Meacher) of an underfunding of pensions, if the earnings link was maintained, of £16 for a single person was not correct. Will he explain why it was not correct and, at the same time, offer the House the opportunity to say that it seems unfair that we cannot get a decent link for pensioners at 4·1 per cent. whereas we manage for ourselves a decent link with earnings of 6·5 per cent.? Why cannot we be linked with pensioners or why cannot pensioners be linked with us?

Mr. Newton: The hon. Gentleman will know—I hope that he will regard it as sensible—that one of the purposes of the new arrangements being introduced in April 1993 is to produce an across-the-board improvement in arrange-ments for community care. Although it could have been argued that the most sensible and logical course would be for everybody to move from the ILF into the new arrangements, which I believe will work well, we have said specifically that those covered by the ILF at the point of changeover—in the same way as we have for the residential care and nursing home limits—will continue to be covered by the existing arrangements. That is a sensible and practical step to ease the transition.
On pensioners, I do not think that I said that the hon. Member for Oldham, West had made a mistake in his mathematics. I have not had the opportunity to check. I did not seek to say that. I said that, if the Labour party's policies on the linking of those benefits had been pursued in the way in which the hon. Gentleman urges, we would have gone straight back to the problems that the Labour Government found—that they could not sustain those commitments. They ended up making pensioners worse off.

Miss Emma Nicholson: Does my right hon. Friend agree that it is not pensioners who are bitterly disappointed by his announcement today, but the Labour party? Its disappointment stems from the magnificence of the increase and the skill in deployment with which he has targeted it on the most needy members of our society. Does he find it especially shameful that the Opposition spokesmen cannot even honestly recognise and accept that we have spent two and half times more than they did in 1979 on that acutely disadvantaged group, the disabled? Is he not ashamed of the Labour party's response?

Mr. Newton: I thank my hon. Friend for her supportive remarks. It is a very remarkable achievement that, by a combination of an improved coverage of existing benefits and the many new steps that we have taken in the past three years, we have so massively increased the amount of support going to that group of severely disabled people.

Mr. Andrew F. Bennett: Although the support that the Government are giving to older pensioners through the extra income support is welcome, does the Secretary of State realise that there is a group of younger pensioners who have suffered a great deal as a result of the Government's policies? They are those put out of work in their fifties, supposedly to make this country's economy work again. In many cases, they have not worked from their middle fifties until their sixties. They are extremely hard up, because they have been on benefits for a long time. Is it not time that the Government targeted some help for them?

Mr. Newton: It will be within the hon. Gentleman's recollection that, although what I announced this afternoon is the premium increase directed to the over-eighties and the more severely disabled less well-off pensioners, last year I made the same sort of real increase in the income support premium for younger pensioners —those between 60 and 74. I thought that the balance this year pointed in the direction that I have announced.

Mr. Andrew MacKay: Is my right hon. Friend aware that colleagues who represent south-east constituencies, who have had especially difficult hardship cases concerning the elderly in residential homes, will welcome the increase in the residential care allowance by £15 to £20 a week? May I underline what my hon. Friend the Member for Brighton, Kemptown (Mr. Bowden) said a moment ago? We still have special problems with the cost of residential care in the south-east. I know that it is difficult for my right hon. Friend to give a regional premium, but I ask him to undertake to look at that matter once more for us.

Mr. Newton: I can, of course, assure my hon. Friend that—as my statement made clear—we shall always continue to keep those matters under review. I cannot undertake this afternoon to introduce a regional premium of the kind that my hon. Friend suggests in advance of the move to community care. Having looked carefully at the figures, however, I believe that the increases that I have announced—particularly the larger increase for the very dependent elderly who are in residential care homes—will substantially ease the problem with which my hon. Friend is rightly concerned.

Mr. Gerald Bermingham: Here we are, at the end of the 20th century. Does the Secretary of State agree that, no matter how the figures are fiddled and regardless of the percentage that is used, the elderly and infirm—the old pensioner and the handicapped person —and, indeed, the single-parent family will still be living in poverty? That is the reality of life for them, now and in April.

Mr. Newton: What I am conscious of is this. The figures suggest that pensioners' average net incomes have risen by some 30 per cent.—rather more, indeed—under the present Government. That is partly because their savings and occupational pensions have been worth more and


partly because the average rate of inflation has been lower. I do not accept the hon. Gentleman's general proposition. What I do accept—and what I have now demonstrated in three successive annual uprating statements—is that for a sizeable group of less well-off pensioners we need to do more and that is exactly what I have done.

Mr. David Martin: May I add my welcome for the £15 uprating for private residential and nursing homes—a form of community care against which the Labour party carries on a relentless and unfair vendetta? May I also thank my right hon. Friend for listening to those of us who want the increases and for acting accordingly?

Mr. Newton: I am grateful to my hon. Friend. I have certainly listened very carefully to the representations that have been made. In the past week, while making my final decisions, I have met the representatives of a number of organisations—such as charitable and other bodies—and care home owners. I very much hope and expect that the large increases that I announced will be helpful to them.

Mr. Dick Douglas: Does the Secretary of State accept that there should be a direct link between growth in earnings and increases in pension payments and that that principle should be accepted by hon. Members on both sides of the House?
I especially welcome the attention paid by the right hon. Gentleman to hospices, but will he explain a little further? Will he ensure that people in hospices—I do not single out any group, but I am thinking particularly of people suffering from AIDS—are not disadvantaged in any way by his proposals?
I know that the right hon. Gentleman is not directly responsible for students, but will he take into consideration the large number of students who are not covered by the proposals, are being denied benefit and are suffering as a result of the Government's provisions?

Mr. Newton: The hon. Gentleman will know that the arrangements under which the student loans scheme was introduced, and the arrangements for access funds, include those about whom he expressed concern.
There are two changes relating to hospices. First, an extra £1 million in grant will be given directly to them; secondly, a change is to be made in attendance allowance and then in disability living allowance rules, which at present have the practical effect of making it impossible for many people in hospices either to continue to receive attendance allowance or to claim it for the first time. That problem will be overcome and the change will be worth just over £2 million to people in voluntary hospices.

Mr. Anthony Coombs: The increased support for the mentally handicapped—not only in residential care, but in the community—is very welcome. Will my right hon. Friend confirm that, over the past 12 years, spending on long-term sick and disabled people has risen from £1,800 million to nearly £13,000 million? Does not that illustrate the Government's commitment to an especially vulnerable group?

Mr. Newton: Yes, it does. As I said in my statement, even when allowance is made for inflation that is an increase of some two and a half times in real terms— which, in my view, constitutes a remarkable record.
I share my hon. Friend's satisfaction with the various ways in which I have been able to steer additional help towards mentally handicapped people. Let me pay special tribute to my right hon. Friend the Minister for Social Security and Disabled People, not least in regard to the ingredient in the new disability living allowance, which will bring extra help to some 10,000 severely mentally handicapped people.

Mr. Harry Barnes: There is a mismatch between the start of the tax year—and hence the uprating of benefit—and the local government financial year. That means that council rent increases take place in advance of upratings. The practical consequence is that many people who can ill afford it lose in terms of benefit and related housing benefit provisions for at least a week or so. Will the Government end that fiddle?

Mr. Newton: Any mismatch between the benefit year and the tax year is very small this year given that we are talking about the week beginning 6 April for the uprating of social security benefits. If the hon. Gentleman wants me to look at the point in greater detail, I will.

Mr. Roger King: Has my right hon. Friend had a chance to reflect on his excellent proposals this afternoon, which included a worthwhile uprating for the basic pension, and on those presented by an alternative political party for a flat rate increase of £5 for a single pensioner and £8 for a couple, bearing in mind the fact that that political party advocates a standard minimum wage? Would not that have a disastrous impact on shop prices and make that party's proposed increase highly illusory?

Mr. Newton: There is no doubt that, no matter which of the various estimates one takes, the introduction of a national minimum wage would increase inflation to the disadvantage of pensioners and, more to the point, put a lot of people out of work.

Mr. William McKelvey: I welcome the extent of the changes in the rates for nursing homes to £15 and £20 for disabled people, but will the Secretary of State take steps to stop the growing abuse of private nursing homes which are seizing people's personal allowances as part of the rent?

Mr. Newton: This point, as the hon. Gentleman will be aware, has arisen on several occasions. It is not a question of seizing anyone's benefit. The plain fact is that benefit is payable to people as individuals and it applies for residential care and the nursing home limit and personal expenses allowance. Only the individual can decide how to use that money.

Mr. Jacques Arnold: Does my right hon. Friend agree that it is better to help less well-off families with the breadwinner in work than to make them unemployed through the imposition of a national minimum wage?

Mr. Newton: Yes, I do, and that is why I and my colleagues are proud of the introduction of family credit and of the success that it is becoming.

Mr. Terry Rooney: The Secretary of State mentioned in his statement the new-found benevolence for the elderly and the disabled. Why has he not tried to deal with the problem of women aged between 60 and 65 who are still disbarred from claiming invalid care allowance and who are dependent on moves in the European Court rather than on this Government?

Mr. Newton: I do not quite know what the hon. Gentleman means by a new-found benevolence, when for three years we have consistently been steering additional help to the groups to whom I have referred: low-income families with children, less well-off pensioners and, not least, disabled people. There is nothing new-found about that. It is a consistent programme which is bringing more help to the groups that we want to help.

Mr. Ian Bruce: Will my right hon. Friend find time to produce figures for the benefit of Opposition Members to show the comparison between the incomes of pensioners in the United Kingdom and those in the rest of the European Community? Will he confirm that often when Opposition Members talk about "state" benefits, they are talking about private benefits from employers and trade union schemes in France and Germany? Will he also confirm that benefits in this country are 34 per cent. ahead for the average pensioner and that benefit is being increased for the poorest pensioners by nearly twice the rate of inflation to ensure that those pensioners receive the greatest benefit?

Mr. Newton: As I have now said several times, pensioners' average net incomes have been rising faster than those of the general population during the lifetime of the present Government. Quite apart from the point that I made about married women's pensions paid on their husbands' contributions, many of the comparisons with other European countries, of which the hon. Member for Oldham, West is so fond, totally ignore matters such as the fact that, in Germany, pensioners will be making health contributions which they would not have to make here.

Mr. Bob Cryer: Does the Secretary of State accept that the increase for pensioners is paltry and will be widely resented throughout the country? On the range of benefits, he knows full well that there is a tendency for administrative means to be used to err on the side of refusing benefits rather than granting them, if there is any sort of discretion. When he puts his statutory instruments before the House, will he state the full range of ministerial directions which accompany them? They should be part of the statutory instruments, and the right hon. Gentleman should not be producing extra legislative power without any authority of the House.

Mr. Newton: Whatever regulations we use to administer the social security system, there will obviously be a need for guidance. By and large, that guidance, unless there is a very good reason for not publishing it—for example, to prevent fraud—is publicly available. I would firmly resist the suggestion that, by back-door means—if that is what the hon. Gentleman meant—measures are adopted to prevent people from getting the benefit that they should get. That is simply not the case. On the contrary, considerable efforts have been made to ensure that benefit gets through to the people for whom it is

intended. That is one reason why the extension of disability benefits and the increased expenditure on them have gone as far and as fast as they have.

Sir Jim Spicer: Does my right hon. Friend accept that all fair-minded people will warmly greet the package that he announced, which amounts to £3 billion? Within that total, the sum of £1 million for hospices might seem small, but that £1 million will act as a multiplier for many people in our voluntary sector, who will turn the sum into many millions of pounds. I thank him for that. As he passes that £1 million to the regional health authorities, will he make certain that Dorchester hospice, which will start work on 6 December, gets its fair share?

Mr. Newton: As I said in my statement, the mechanism will be a transfer to the Secretary of State for Health for distribution under the scheme that he already has for direct help to hospices. I should make it clear that the total amount of benefit that I expect to be gained by hospices arising from this afternoon's statement is not £1 million but £3 million. I certainly undertake to draw to my right hon. Friend's attention, as they say, my hon. Friend's plea on behalf of his local hospice.

Several Hon. Members: rose—

Mr. Speaker: Order. We have a busy day, but I shall allow questions to continue until 4·45 pm and then we will have to move on.

Mr. Harry Cohen: Has the Secretary of State noticed that fares in London and the south-east are due to rise by more than 8 per cent.? Why has he not taken that into account in setting the income support level? Does he realise that a five-day travel pass costs the equivalent of 35 per cent. of a single person's income support? Why does he not take that into account? Would he like to live on £28 a week for housing, poll tax, eating, heating and everything else?

Mr. Newton: The hon. Gentleman will realise that for many years it has been the practice to base upratings on the latest available information about what has happened to prices. That remains the sensible course. It is also worth making the point that it seems likely that, by next April, the rate of inflation will be lower than it is now.

Mr. Harry Ewing: May I press the point that was made by my hon. Friends the Members for Monklands, West (Mr. Clarke) and for Kilmarnock and Loudoun (Mr. McKelvey) on the residential care and nursing home allowance? Does the Secretary of State accept that more than 90 per cent. of beneficiaries will not receive that benefit? It will go straight to the owners of residential homes and will make no difference at all to the pocket money that beneficiaries receive. Has not the time come for a royal commission on the operation of residential homes and nursing homes? When highly paid professional football players in Scotland are told by their financial advisers that the best investment is in one of those residential homes, it is time to worry. I wonder whether the Secretary of State shares my view.

Mr. Newton: The hon. Gentleman knows that the Government have made wide-ranging proposals, which are now building up towards implementation, to change the whole nature and basis of those arrangements in what


he and I would regard as a more sensible direction from April 1993. What I have announced today is an increase in the income support limits within the present structure. That, too, is sensible.

Mr. Tony Banks: How much money have the Government saved since the abolition of the single payment system? Is it not now running into hundreds of millions of pounds? Is not it grotesque that people who badly need loans are often judged as being unable to pay them back and so are refused? Is not that hypocrisy and injustice on the part of the Government?

Mr. Newton: The single payment system was unsustainable and had become increasingly open to abuse. Resources for the social fund have been substantially increased by what my right hon. Friend announced in August and what I am carrying through to next year.

Points of Order

Mr. Martin M. Brandon-Bravo: On a point of order, Mr. Speaker. I have given you notice of my point of order, and I also conveyed my intention to the hon. Member for Nottingham, North (Mr. Allen).
The ability of hon. Members to petition on behalf of their constituents is a treasured privilege. That privilege was abused last Friday, when the petition that was presented to you, Mr. Speaker, was based on a fraud. Signatures were fraudulently collected and sought to give credibility to that fraud. There never has been, there is not, nor is there going to be any likelihood of the Nottingham city hospital or the Queen's medical centre in my constituency being taken out of the national health service.
I will acknowledge that the form of the petition must have been correct, Mr. Speaker, or your office would not have accepted it. However, I ask whether it is possible for you to investigate how the other signatures were collected, for I believe that those people were unaware of what they were being asked to sign. [Interruption.]

Mr. Speaker: Order. The hon. Member is quite right. The petition was in order when it was presented to the Table Office, and the Table Office accepted it in good faith. It is not for me to judge its accuracy. I should call the hon. Member concerned.

Mr. Graham Allen: The signatures on the petition were collected by Alan Simpson, the next Labour Member for Nottingham, South, and myself. They came from thousands of people in Nottingham—health workers, doctors, nurses and patients—all of whom know that the Nottingham city hospital opted out last Wednesday. If it is of assistance to you, Mr. Speaker, I will read the full text of the petition. It states: "We"—[Interruption.]

Mr. Speaker: Order.

Mr. Allen: I am trying to be helpful.

Mr. Speaker: Not now. [Interruption] Order. The petition was properly presented on Friday. It would have been open to the hon. Member to include a number of signatures on the hand-written top sheet of his petition. That did not happen. Nevertheless, as far as the Table Office was concerned, the petition was in the correct form.

Mr. David Ashby: Further to that point of order, Mr. Speaker. What are hon. Members supposed to do when petitions are put forward which are totally misleading and totally misrepresent the situation? We have even seen such a petition held up by the hon. Member for Nottingham, North (Mr. Allen). He seems to be happy to have presented a misleading petition to the House. What are we to do in those circumstances?

Mr. Speaker: I cannot advise the hon. Member on tactics of that kind. I am concerned only with whether the petition was properly presented, and I have to say that it was.

Mr. Dick Douglas: On a point of order, Mr. Speaker. I have a great deal of sympathy with you because of the onerous responsibilities facing you, especially as we approach the intense battle of a general


election. However, may I prevail upon you, in the coming short recess, to examine your responsibilities in relation to the Representation of the People Acts? According to the motions on the Order Paper, today's debate will be an exclusively English debate on the health service—[HON. MEMBERS: "No."] If that is indeed the case, we shall have no opportunity of raising the position in Scotland and the fact that the Secretary of State for Scotland and his Minister of State are at odds on the issue of hospital trusts in Scotland.
We cannot question a Scottish Office Minister today, and if I were to raise this matter with the Secretary of State for Health, he would say, "This is a matter for my right hon. Friend the Secretary of State for Scotland, and he will reply." May I have your assurance, Mr. Speaker, that in future, and especially in a general election or by-election period, you will seek to ensure that such debates are not dominated by Front-Bench speakers as happened during last Monday's defence debate when, although you asked for short speeches, the two Front Bench spokesmen consumed two hours—[Interruption.]

Several Hon. Members: rose—

Mr. Speaker: Order. We should get on with it. The debate is certainly not limited to England and Wales and I hope that, with any luck, when we get to it, I shall be able to call some Scottish Members.

Mr. Harry Ewing: On a point of order, Mr. Speaker.

Mr. Speaker: Well, what else?

Mr. Ewing: If you are to make the Representation of the People Acts your bedside reading during the short recess, perhaps you could consider the position of an hon. Member who is elected under one political banner but who then changes party—[Interruption]

Mr. Speaker: I am not certain that I shall he reading those Acts.

Mr. Douglas: rose—

Mr. Speaker: Order. I am now pretty certain that those Acts will not be part of my bedside reading in the short recess.

National Health Service

Mr. Speaker: I must announce to the House that I have selected the amendment in the name of the Leader of the Opposition and that, because no fewer than 44 right hon. and hon. Members have already sought leave to speak in the debate and hope to be called. I therefore propose to put a limit of 10 minutes on speeches between 7 and 9 o'clock.

The Secretary of State for Health (Mr. William Waldegrave): I beg to move,
That this House welcomes the record extra resources provided for the NHS and the substantial increase in the number of NHS patients treated since the Government came to office in 1979; supports the Government's reforms of the NHS which are already bringing about improvements in patient care; deplores the intellectual bankruptcy of Her Majesty's Opposition which, bereft of any coherent proposals of its own for the modernisation of the National Health Service, is reduced to peddling smears and scares which lower morale amongst NHS staff and cause wholly unnecessary fear amongst patients; notes with approval the Prime Minister's unequivocal statement on the NHS that there will he no charges for hospital treatment, no charges for visits to the doctor, no privatisation of health care, neither in part nor as a whole, now or in the future; and welcomes his unequivocal assurance that Trust hospitals remain a permanent part of the NHS.
The Government have chosen to hold this debate today to show the House and the country three things. First, we intend to nail the falsehood that was put at the heart of Labour's campaigning ever since the notorious Monmouth by-election—that the Government intend to privatise health care in Britain and that NHS trusts are leaving the health service. Secondly, we intend to dissect and record for the House the increasingly desperate and contradictory shifts of line made by Labour over the past few weeks, as it has been forced to retreat from allegations which it knows to be false. Thirdly, we intend to demonstrate to the House what is already established among independent experts and commentators outside —that Labour has no serious policy for management of the health service and no position that stands up on money for health, and that it is our domination of the real agenda which has forced it to resort to a truly scurrilous campaign of smears and scares.
I will start by nailing once and for all the falsehood about privatisation. First, let us remember Labour's first version of that falsehood. It started with mendacious leaflets at Monmouth saying that the local trust hospital would be leaving the NHS. It went on with the right hon. Member for Manchester, Gorton (Mr. Kaufman) saying that the Prime Minister would privatise health just like coal and steel. Then we had the hon. Member for Livingston (Mr. Cook) saying, "We all know what the Tories do with nationalised industries, don't we? They privatise them," and the hon. Member for Copeland (Dr. Cunningham saying, "They will finish up selling off hospitals and privatising the health service".[Interruption.]
Before Labour Members who are less well briefed start to cheer, I should point out that those were the allegations endorsed by the Leader of the Opposition's speech writers in Brighton, when their leader said:
The Tories will privatise the Health Service.
It was simple. It was straightforward. It was false. But that is not what Opposition Members are saying now. The trouble with accepting advice from the ragbag collection of


advisers who make up Labour's policy now is that it does not have to face interrogation from this House or from interviewers outside. Under those pressures, Labour has been redrafting and redefining—like the late Dr. Bowdler trying to rewrite Shakespeare without the naughty bits. We get six redefinitions a day; we get backing and filling; we get wriggling; and finally we get retreat.
It took six pages of the transcript of the hon. Member for Livingston's interview with Mr. Walden for that redoubtable interviewer to get to the truth. Mr. Walden said:
Ah, well, now it's becoming clearer to me, and how wise we were to have this discussion, because you are not saying, are you, that the Conservatives intend to sell off the public institution called the National Health Service to private interests?
Then came the answer from the hon. Member for Livingston:
"No".
So much for his leader, so much for the hon. Member for Copeland—wherever he is—who rejoices in the title of Labour's campaign co-ordinator; so much, for what it is worth, for the right hon. Member for Gorton—people always seem to be treading on him, poor fellow. The hon. Member for Livingston admits that the answer to the privatisation smears which his colleagues have perpetrated is "No". The hon. Gentleman should have the courage here and now to give the same clear, single-syllable answer to this House that he shared with Mr. Walden and the viewers. Why does he not just give us the same unequivocal "no" today?—[HON. MEMBERS "Answer."] I fear that the strings of the puppet have been pulled once again in a different direction.

Mr. Dennis Skinner: On the subject of that Walden programme and retreating, will the right hon. Gentleman explain why he found it necessary to say that the Government would stop making charges for fertility treatments at hospitals such as Bart's when a letter was sent to him on 19 August saying that that was illegal, but he did absolutely nothing about it? The right hon. Gentleman retreated only when Walden asked him that question. The truth about the right hon. Gentleman is that he is educated beyond his intelligence.

Mr. Waldegrave: There is no danger of that with the hon. Gentleman. His intervention enables me to say once again, and to make it as clear to the House as I made it on the "Walden" programme—and as clear as we have made it in the past and as clear as we will make it again in the future—that one cannot do that:it is illegal to charge NHS patients.
We all know how Labour has sought to back-track in the past few days.

Mr. Tom Clarke: rose—

Mr. Waldegrave: No doubt we shall come to the hon. Gentleman in due course.
We know how Labour has sought to back-track in the past few days. We have privatisation replaced by creeping privatisation; we have creeping privatisation replaced by commercialisation, and falsehoods replaced by creeping falsehoods.
Let us examine some of the new definitions. One line is that having charges for some items of service in the NHS

is privatisation. In that case, the very founder of the NHS invented privatisation. It was Aneurin Bevan who passed the legislation for prescription charges, and it was a Labour Government who introduced charges for teeth and spectacles.
There have always been some charges for some services in the NHS, under Labour and under the Conservatives. The proportion of the income of the service which comes from patient charges is actually lower now than it was in the 1950s. We did abolish universal free eye tests and dental check-ups and introduce charges for those able to pay—as is well known—and it was controversial at the time; just as Labour introduced the original charges for teeth and spectacles, and just as, in 1967, they reintroduced the prescription charge having rashly abolished it—[HON. MEMBERS:"Ah."] There has been, and there will be, no fundamental shift away from a service financed overwhelmingly from taxation.

Mr. Rhodri Morgan: rose—

Mr. Waldegrave: If charging is to be the definition of privatisation, it was the hon. Gentleman's party who invented it. I give way to him.

Mr. Morgan: Although I did not see the programme, I understand that the Secretary of State said that it was illegal to charge for any health service except eye tests, prescriptions and those which he has just identified. If it is illegal, will he do something about the practice of one of the hospitals that serves my constituency of charging for nebulisers? It prescribes nebulisers, which are vital for people suffering from emphysema and acute bronchitis, and tells them—

Madam Deputy Speaker (Miss Betty Boothroyd): Order. The hon. Gentleman is making a speech, not an intervention. This is delaying the Secretary of State. I think that the Secretary of State has got the point.

Mr. Waldegrave: The position is entirely clear. NHS patients cannot be charged and will not be charged. [HON. MEMBERS: "Answer the question."] I have answered the hon. Gentleman's question. NHS patients cannot be charged. [Interruption.] I have given the hon. Gentleman the absolutely clear answer that he asked for, and that is the truth.
Yet another redefinition comes from the Leader of the Opposition. Needless to say, his does not work either. In his version of the policy, he says:
Up to now, care for elderly people has been free.
This is an important matter. Like most of his pledges, it involves some billions of pounds of expenditure. Up to now, we have pursued a policy, supported by both sides of the House, called "Caring for People". The White Paper was supported by the right hon. Gentleman and the Labour party.
If the Leader of the Opposition is now saying that the transfer of people from wards in acute hospitals into the community, where they are supported by my right hon. Friend the Secretary of State for Social Security through the Department of Social Security, is to be abandoned by the Labour party, that is yet another commitment which involves billions of pounds of expenditure and will result in less good treatment for patients. The Labour party should come clean on that. Is it abandoning care in the


community or not? If it is, that is an astonishing reversal, which would not only bring huge new pressures to bear on NHS hospitals but be worse for patients.
Then we come to the hon. Member for Peckham (Ms. Harman). Retreating off that ground, she has dug Labour into another hole. Privatisation as she defines it means high waiting lists. If that is so, Labour is the prince of privatisation. There has never been a Labour Government who did not leave waiting lists higher than they found them. What is more, as the hon. Member for Livingston knows full well, even if the hon. Member for Peckham does not, on a fair and comparable basis waiting lists fell between 1979 and now.
I give the figures for England. In March 1979, the number was 752,000. In March 1991, it was 693,000. I would like the hon. Member for Livingston to repudiate the briefing note that he has put round the country and which has been sent to me from a variety of places. It says that his figure of approximately 900,000 for now is for England, "excludes self-deferred cases"—so far, he is right —and
includes waiting lists for day surgery, which were collected separately from 1987.
That is totally dishonest, because the truth of the matter is that the figures were not collected at all before 1987— not that they were collected separately. The hon. Gentleman is an honest man and he should repudiate that. He knows perfectly well that he gets his higher figure by including day patients, figures for whom were not collected before 1979. He should have the honesty to admit it. [HON. MEMBERS: "Answer."] We will not get any answer.
The next argument of the hon. Member for Peckham was that we were driving people into the private sector. [HON. MEMBERS: "You are."] Opposition Members should wait before they cheer. This one lands them in a hole as well, I am delighted to say. The single year when the largest rise in the percentage of the population covered by private insurance took place was 1979—a 28 per cent. increase. No one can doubt what caused that. It was caused by Confederation of Health Service Employees pickets controlling access to the cancer wards and by the total collapse of the service. In short, Labour's running of the health service was the best recruiter for private health care that there has ever been.
Big falsehood, little falsehood, creeping smears, smears that bellow in the tones of the hon. Member for Bolsover (Mr. Skinner) or in the dulcet tones of the hon. Member for Livingston: in the past two weeks we have nailed them all. Labour took its campaign a smear too far and it knows it. It was the politics of hit and run, and the House will not let Labour Members get away with it.
Meanwhile, at Langbaurgh, the two candidates for the main Opposition parties have been following their leaders into total confusion. First, the Labour candidate. Labour's candidate in the by-election is repeating the tired and false old allegations about trust hospitals leaving the NHS. I am also told that that is not his only error. It seems that, in his election literature, he lists two hospitals as part of the new South Cleveland trust. In fact, there are three. It is a pity that his slogan is:
It's time to make Langbaurgh count".
Then there is the unfortunate Liberal. He has joined in with a finely printed leaflet. He was selected, the hon. Member for Bolsover may be interested to know, for his local knowledge. He has led a great campaign on the closure of the maternity unit in Gainsborough. He is not

going to have the closure of the maternity unit in Gainsborough. Unfortunately, Gainsborough is in the next county—it is Guisborough. I am afraid that the candidate is a little askew.

Mr. Simon Hughes: I am grateful to the Secretary of State for giving way, because I was in Guisborough maternity hospital this morning. [Interruption.] If the Tory candidate thinks that dealing with a printer's error which was accepted as such is a way to win a campaign, he has something else coming. I want to ask the question put to people who go to the maternity hospital, and I hope that the Secretary of State will answer it. Why do not his Government commit the resources sufficient to make sure that the NHS has the money that it needs—[HON. MEMBERS: "How much?"] I will tell Conservative Members how much—to keep pace with NHS inflation, which is above the average inflation? Why do the public expenditure plans of his Government show that the figures for the next two years are net increases of 1·2 per cent—.

Madam Deputy Speaker: Order. I have already made it clear that interventions should be interventions. They should be specific questions or comments which are to the point. It is unfair of hon. Members to seek to jump the queue in this way. I tell the hon. Member and any other hon. Members who want to intervene that I want specific questions from now on. Come on Mr. Hughes, get it over with.

Mr. Hughes: Why are the commitments in the public expenditure plans 1·2 per cent. and 0·65 per cent. for the next two years—well below the least estimate of what the NHS needs to stand still?

Mr. Waldegrave: The hon. Gentleman is suffering from what is known as post-candidate selection depression. These matters will be dealt with when the autumn statement comes out. The hon. Gentleman was honourably trying to dig his candidate out of the absurd hole into which he had fallen head first, and I pay tribute to him for that.

Mr. Tim Devlin: I wonder whether my right hon. Friend is aware that the position is in fact rather worse than he fears? When the Labour candidate in Langbaurgh was asked to explain why he thought that there were two hospitals in the trust instead of three, he said, "Ah yes, that is because only two of them are in the constituency." That makes it rather worse, because none of the three hospitals in the trust is in the constituency.

Mr. Waldegrave: Neither of the Opposition parties has been very lucky with its candidate in this particular election campaign.
The reason why the Labour party took off into the smears and scares was because of the third point, to which I am coming.

Several Hon. Members: rose—

Mr. Waldegrave: Hon. Members will doubtless make their speeches in due course.

Mr. Tom Clarke: On a point of order, Madam Deputy Speaker. You will recall that, 20 minutes ago, the Secretary of State said that he would give way to me. Is it in order for the Secretary of State for Health in England,


who made statements on television yesterday about the health service in Scotland, to refuse to give way to a Scottish Member?

Madam Deputy Speaker: So far there has been no breach of Standing Orders. The Secretary of State will have heard what the hon. Gentleman has said.

Mr. Waldegrave: The reason why Labour Members went down the side track of smears and scares was because of the drubbing that they had been receiving at the hands of the experts on their policies, such as they are. Seldom has there been such a consensus among health experts— generally an argumentative lot—than there is now on the fact that Labour's positive policy on health has been an object of almost universal derision.
Ken Judge, the director of the much respected King's Fund Institute, said:
One of the key difficulties"—
key difficulties, mind you, not one of the lesser difficulties—
with Labour's health policy is that it is not at all clear precisely what their policy for running the system is.
Pamela Charlwood, director of the Institute of Health Services Management, called Labour's plans to replace the purchaser-provider division with health authorities divided into two boards as "an unworkable mess". Professor Alan Maynard of York university asked of Labour's absurd flexi-funding scheme:
Where is this extra money coming from? Are there going to be closures and sackings? How do they identify successful authorities? They haven't thought it through.
Dr. David Hunter, director of the Nuffield Institute, who, incidentally, has been trying to help Labour Members in one of their think tanks, said:
Labour plans have not been worked through in detail. They are not convincing. They would create further turmoil and uncertainty.
Yesterday he added that he feared that under Labour the NHS would not be "modernised", it would be "fossilised."
That is why there is not a single serious editorial or other commentator who takes Labour seriously on its policy. The Observer's political diarist, not in his comments a particular friend of mine, described the policy of the hon. Member for Livingston thus:
He does not possess a single new idea for organisation of the Health Service. His one notion is to throw more money at it in carefully unspecified amounts.
At this rate I must warn the hon. Gentleman that it will not be long before he is attacked by the Daily Mirror. After all, Labour Members have not had long. They have had only 12 years. Perhaps in another 12 years they will have a policy. We shall see that they get the time.
Then there is money. Labour Members are not very good at money. I pay tribute to the hon. Member for Livingston in one respect. He shares his favours equally; having spent last Sunday going backwards on the Walden show, he spent this Sunday going backwards on the Dimbleby show. There was the truly comical spectacle of him trying to make sense, either to himself or to Mr. Dimbleby, of his flexi-budget. It became crystal clear that, if such a scheme were ever to be introduced into NHS management, it would be a recipe for chaos. Every hospital would he encouraged to compete for incentive funds, and only the winners would be rewarded. The

others would go bust. Mr. Dimbleby could not take it seriously. What was apparent also was that neither could the hon. Member for Livingston.
Far more fundamental was the hon. Member's further shifting of the ground on money. He could not define what he meant by underfunding, and he abandoned his clear previous pledge to abolish it, whatever it might be, over the lifetime of a Parliament. In passing, he had a snipe at the hon. Member for Derby, South (Mrs. Beckett) who had made it clear that only some of the alleged underfunding, whatever it might be, could be put right in a Parliament. He told her that she should not give interviews. It was a truly magnificent piece of the equivocation for which the hon. Gentleman is becoming increasingly known.
I shall tell you, Mr. Speaker, what the hon. Gentleman's formulations on spending were on Mr. Dimbleby's show. I noted them down. They started with something that almost means something:
We have made a firm commitment, and I am very happy to repeat the firm commitment, that we will over the lifetime of the next Parliament—it cannot be done overnight—we will restore the underfunding of the NHS of the past decade.
That was in January. Yesterday it became first, "We will", then, "We very much hope" and finally, "We will seek" —the ultimate weasel word. The hon. Gentleman will seek and he will not find.
When cornered this time, the hon. Gentleman did not take refuge behind the right hon. and learned Member for Monklands, East (Mr. Smith), his usual shelter from the stormy blast. He called in aid in a voice of awe the "ultimate authority". By that he meant—I am afraid I am not joking—"our leader, Mr. Kinnock". The latter, however—he is sitting smiling in his usual benign and somewhat vacuous way—had already involved himself in quite another pledge, involving £3 billion to £4 billion of different money.
The hon. Member for Livingston referred to such promises as "interesting contributions", "persuasive" and "a very serious figure". Finally, he said:
I am not in a position to differ from them, but equally I am not in a position to validate
them. As a recent leader in The Times said of Labour:
Their undefined `restoration of underfunding' is designed to permit everybody, from consultants to porters, to think that Santa Claus is round the corner. They remain as ever, a gigantic soft touch.

Mr. Tom Clarke: rose—

Mr. Waldegrave: I must let the hon. Gentleman out of his agony. Come along.

Mr. Clarke: I am grateful to the Secretary of State for finally giving way. He is making it more difficult for me than Brian Walden did for him yesterday. When the Secretary of State was asked a specific question about charges in Scotland, including charges for HIV patients, and he gave the reply which led many of us to believe that those charges would be annulled, had he consulted his fellow Ministers at the Scottish Office? If not, has he now done so? If there have been consultations, when will the charges be withdrawn?

Mr. Waldegrave: There is no need to consult about what the law of the land is, and that is the end of that matter. [Interruption.] There is no lack of clarity about it whatever. NHS patients cannot be charged.
It is not just that Labour Members cannot substantiate the half-promises on resources that they have made. It is


worse than that. On a range of issues, they have made unequivocal promises to reverse savings that we have made, the benefits of which we have already ploughed back into patient care. They would end, for example, the contracting out of services, which has gained us a minimum of, and probably much more than, £50 million for spending on patients.
Yesterday, the hon. Member for Livingston pledged an additional £400 million to £500 million, which would be taken from patient spending and would finance Labour's absurd minimum wage plans in the NHS. I am grateful for his unusual candour, in that he said £400 million to £500 million. He continued in a totally absurd passage to say that that would be "largely self-financing" because he would take all the money away again in tax. I believe that the hon. Gentleman may have let some small cat out of the bag about what would happen to the taxation rates of the low paid. What else can "largely self-financing" mean?
Let us get this clear: Labour is already pledged under its national insurance and tax proposals to take £20 a week from the average nurse and £70 a week from the average general practitioner. The House should be told today whether it is now pledging to reverse those cuts in take-home pay for health service workers, gross or not. If it is not, all those health service workers know that, if the Labour party is elected, they will lose in real terms, as they did under the last Labour Government. We will not get the answer to that, any more than we will get an answer to anything else from them.
The Opposition made another utterly disastrous pledge yesterday. They have promised to launch the health service down the route that Barbara Castle launched it down in the 1970s. That promise comes from the otherwise normally thought of as the oh, so responsible right hon. and learned Member for Monklands, East. Yesterday, he made it clear on yet another television show that the Labour party intended to remove pay beds from the NHS. That will take another £100 million.
That money will be lost to the NHS and given to the largely French and American-owned private sector health companies—those companies that Lord Ennals and others direct in Scotland and elsewhere. Why should the NHS not have the opportunity to make that money for patients? It could plough that money back into the system for NHS patients. Why should it be forced to lose that money? That is what Barbara Castle attempted to do and that is what brought her into total conflict not only with the British Medical Association, but with the entire health service.
Barbara Castle is an honest lady, and she wrote down in her diary the reason for the policy—the hon. Member for Bolsover knows this very well, as he reads those diaries every evening. She wrote:
doesn't the Government; realise"—
the then Labour Government; Ted Short was giving her some trouble on this rather absurd policy—
that this is an essential political sweetener for the Unions?
That is what generated the Labour Government's apology for a policy then, and that is what generates the Opposition's apology for a policy now.
Throughout the world, Governments of all political persuasions are seeking with greater urgency to match scarce resources with the increasing demand for health care. In Germany, the Netherlands, Spain, Sweden and New Zealand, the ideas that we are carrying through into practice have been paralleled, or indeed, in some cases, imitated, by other Governments.
It is right to devolve decision taking, as we are doing, to NHS trusts and to general practice fund holders. It is right to enable comparison of costs to be made by those who have to judge where to put resources. It is right to reward with more resources, so that they can do more work, those who are the most efficient at delivering high-quality health care. That is what our internal market is now beginning to do.
It is right also to raise the total level of resource to meet new needs, as we have done. At a time when other countries are seeking to rein back spending on health, we have been increasing the share of the gross domestic product that goes to the health service. In the past 10 years, there has been a full percentage point increase in spending from a bigger national product.
It is fear of those facts and of the void of their own policy that has led the Opposition to smear and to mislead. But it is not too late even now. Even at this late stage, the hon. Member for Livingston could redeem himself today before the House by setting out in paragraphs preferably a little shorter than those he used on the "Walden" programme three simple things. First, he should say that he knows the privatisation smear to be false. Let him say that and use that "no" as he did on the Walden programme. Secondly, what are his plans for the management of the health service? Let us hear about them at last. Thirdly, how much money is he going to spend? Let him say those three things to the House today. He has had 12 years: we might at least have some answers finally.
We could hardly have had a clearer example again today of the shiftiness of the Labour party on this issue. Our policy is clear. As my right hon. Friend the Prime Minister said—I repeat his words in the House today—
There will be no charges for hospital treatment, no charges for visits to the doctor, no privatisation of health care, neither piecemeal or in part, nor as a whole. Not today. Not tomorrow. Not after the next election. Not ever while I am Prime Minister.
That is what my right hon. Friend said, and that is the truth. [HON. MEMBERS: "Hear, hear."]
What we have achieved on spending and what we intend on policy is crystal clear. It is underpinned by clear commitments in the pledges and principles that are placed before the House today. That is why I urge my right hon. and hon. Friends to reject the amendment and to support the motion.

Mr. Robin Cook: I beg to move, to leave out from "House" to the end of the Question, and to add instead thereof,
`deplores the decision of Her Majesty's Government to ignore the evidence from the consultation period that the overwhelming opinion of the local public and health staff was opposed to the commercialisation of their health service by further units opting out of the local health service; condemns as irresponsible the approval of further trust applications in the face of the widespread financial difficulties experienced by existing trusts with their original business plans; rejects the relentless privatisation of health services by the construction of more private wings, the transfer of geriatric care to nursing homes, the increased introduction of private contractors, the decline in access to a National Health Service dental service, and the introduction of tax relief on private medicine; notes with alarm the spreading practice of charges for hospital services and the damage done to eye screening by the introduction of commercial charges for eye tests; regrets the persistent refusal of Her Majesty's Government to recognise the self-evident underfunding of the hospital service and rejects the priority attached by Her Majesty's Government to


cutting taxes rather than restoring cuts in public services; and commends Labour's policy document "A Fresh Start for Health" as the comprehensive basis for renewing a public health service over the lifetime of a full Labour Government.'.
The 900,000 people on the waiting lists in Britain and the 300,000 people who had their operations cancelled in the past 12 months would all regard the speech that we have just heard as wholly irrelevant to why they cannot get the health care that they need.

Mr. Peter Thurnham: rose—

Mr. Cook: With respect, it is not the form to intervene within the first 30 seconds of a speech.
The Secretary of State accused me of retreating on my statement. If I was so minded to retreat on anything I have said, I could not hope to rival the speed with which he moved in retreating on tax relief only yesterday. I apologise to the Secretary of State for one thing; we drafted our amendment before his revelation on the Walden programme. Had we known about that before, we would have wished to include in it the right hon. Gentleman's cheerful confession that tax relief for private medical insurance did not work very well, that not many people had taken it up and that they might as well abolish it. All we need to complete the act of repentance is a letter from the right hon. Member for Finchley (Mrs. Thatcher) to say that she was
only too painfully aware that I was responsible", and was "mystified" that it was such a flop.
Six months ago, at the start of a previous debate, I told the House that the scheme for private medical insurance, far from working well, was not working at all. Far from resulting in more elderly people choosing private medical insurance, all the scheme has done is provide tax handouts for people with existing policies—a tax handout at a total cost of £150 million over three years. That money would have been far better spent on the geriatric wards that the Government are closing.
That daft scheme came out of the same review that gave us the dogmatic changes to the NHS that the Government are now imposing. It was the first proposal in their White Paper to be implemented; now it is the first to be, abandoned.
After that experience, one might have thought that a touch of humility would have been appropriate among those on the Treasury Bench—possibly a passing cloud of self-doubt. Not a bit of it. Never mind the fact that the one part of their policy of which we have had two years of experience has turned out not to work very well, the Secretary of State has chosen to kick on regardless.
Last week, the right hon. Gentleman put another 99 units into his giant experiment with the health service when he made them self-governing trusts, but there is plenty of evidence that those trusts are not working very well. Central Manchester is in deficit of more than £1 million, interestingly almost half of it caused by losses on its new private wing. It is a bit like the tax relief on private medical insurance—not many people wanted to take up that option. The people of Manchester, had they been asked, would have preferred that money to be invested in national health facilities rather than in a private wing.
The Bradford trust has given us another new first in businesslike methods. At the weekend, Bradford an-nounced, for the first time in its history, compulsory

redundancies of nursing staff. Mind you, the director of nursing could not bring himself to use the term "compulsory redundancy": he described the nurses as being "released". They were released because the ward in which they worked, which currently treats 34 patients a week, is to be closed next month.
In search of the common ground, let us put to one side the argument between the Opposition and the Government about whether one can close beds and increase patient care at the same time. I concede that nursing staff and others have been extremely inventive in coping with bed closures, even down to inventing "hot bedding" by which day cases occupy the beds in which in-patients sleep at night. However, I hope that Conservative Members will not now pretend that one can reduce the number of qualified nurses and increase patient numbers without the quality of care suffering. Yet the Library advises me that the next statistical bulletin will say that, in the past year, 3,000 fewer nurses have been employed in the health service, at the very time when the Government have increased the number of administrators by 4,000.
The subject of administrators logically brings me to Guy's hospital, where we find the best paid health administrators. Guy's currently spends more in its business budget for the current year and is receiving less in revenue than it expected in the current budget. Estimates of how much less revenue it is receiving are subject to a wide margin of error. In the case of work outwith the main block contracts, the estimates of how much has gone unpaid vary from an official figure of 50 per cent. unpaid to an unofficial figure of 95·5 per cent. Guy's response has been another business first for the NHS: it has sent packing its director of finance, with a farewell deal of £200,000 plus his BMW car. Is that what the Secretary of State meant when he promised to bring modern business practices to the NHS? Where is the value for money for patients in that?

Mr. David Wilshire: Before the hon. Gentleman knocks management and administration too much, will he comment on the fact that some 3 per cent. of NHS employees are managers, whereas Britain's biggest manufacturing industry has over 20 per cent?

Mr. Cook: Absolutely. The hon. Gentleman's question goes to the heart of why we resist the Government's changes. The kind of market that they propose cannot be run without a much larger army of administrators than any business ever has. If the hon. Gentleman wants to compare the NHS with the private medical sector, never mind private industry, he will find that the administration in the NHS is half the level of the private medical sector. Why, then, should we copy their methods? Surely they should copy ours.
We know that the Secretary of State recognises those problems. He has not managed to muster the same candour as he did in relation to tax relief, but he has kicked into touch the other applications for trust status in London. Instead, we are to have a committee of inquiry for London. It is more than a year since I published a leaked document from his Department warning Ministers —admittedly, his predecessor—of the consequences of a market for the London health service. It warned that the consequence would be "unplanned downsizing", and that at least one major hospital would be put at risk. However,


the Secretary of State's predecessor did not listen: he simply ploughed ahead. The Secretary of State even allowed Guy's to become a trust, although we now know that it had the worst of six ratings for financial viability from his independent advisers.
A year later, nine out of the 12 London teaching hospitals are in deficit. Some of them are contemplating severe downsizing. In the fix that the Secretary of State got into, he was absolutely right to appoint a committee of inquiry, but it was absolutely wrong for him to go ahead with his risky experiment without having a committee of inquiry at the beginning.

Mr. Andrew Rowe (Mid-Kent): Will the h on. Gentleman explain why, with a rapidly falling population, London should be so grossly over-hospitalised, while areas like mine have been deprived of much-needed resources for many years because of the concentration of resources in London?

Mr. Cook: Let us take the logic of the hon. Gentleman's question. He says that London is over-hospitalised and there is over-capacity. One could challenge that statement, but let us accept the premise of the question. If there were surplus capacity, surely competition in a health market would work. Surely this would be the one place where there would be a buyer's market and where practices could drive a hard bargain on behalf of the patients. If the Government really believe in the market, why have they now had to admit that the only way to run a public service is by proper, sensible public planning?
If the Government have decided that, in this case, where they have surplus capacity, they cannot run a market in which there is competition, why are they promoting a market in health care without the benefit of a committee of inquiry in places such as Aberdeen, where the only hospital for 15 miles in any of three directions is a hospital that is applying to become a trust? Where is the competition in that? What conceivable gain can be achieved by creating a market for that one hospital? Consultation on the application for that trust for Forresterhill hospital closed in the same week as the by-election in Kincardine and Deeside started.
Were the Secretary of State a resident of my home town of Aberdeen and a voter in Kincardine and Deeside, he would have some difficulty when he went to the polling booth for the by-election and sucked his pen, because every candidate in the by-election is opposed to his policy. I cannot tell the House the results of the by-election but I can give the results of the consultation on the application for trust status for Forresterhill hospital. A total of 3,919 responses were received; 13 were in favour of the application for trust status; and almost 3,900 recorded opposition to the trust. How can there be any doubt about the response to that consultation? How can anyone pretend that consultation would be anything but a sham if the Government even contemplated approving it? How can the Government seriously hope to fight a by-election—

Mr. Ian Taylor: Answer the questions.

Mr. Cook: If Conservative Members want questions, they should answer this question before that by-election: what will the Government do for Forresterhill hospital, and will they make it opt out once polling day is out of the

way? Moreover, since Conservative Members are so keen on questions, let me ask another question that we asked last week and to which we are still awaiting an answer.

Mr. Roger Gale: Will the hon. Gentleman give way?

Mr. Cook: No. Conservative Members wanted questions and we shall give them questions. Does it never cross their minds that, when the public are so opposed to a proposal, it is just possible that the public are right? The public are right to believe that they would get better health care if an integrated public service was retained rather than broken up into competing businesses.
This morning, the Secretary of State said that he did not understand what we meant by "commercialisation". Let me try to help. Last summer, I asked for the business plans of hospitals seeking to become trusts in this round. Three out of four refused. Interestingly, the most common reason for refusing—

Mr. Phillip Oppenheim: Will the hon. Gentleman give way?

Mr. Cook: I can never refuse the hon. Gentleman. I shall give way when I have finished this passage.

Mr. Waldegrave: The hon. Gentleman has gone off, in his usual way into past speeches. Will he answer the questions that I asked him? He gave no answer whatsoever to the three questions that I put to him. Will he now honour the House with his confidence and give those three answers?

Mr. Cook: If the Secretary of State is patient, he will get to those passages and he will have some answers. I do not promise that he will like the answers, but he will certainly get some.
First, may I help the Secretary of State on the term "commercialisation"? The most common reason given by those hospitals that refused to release their business plans was that the information that they contained would be of value to a commercial competitor.

Mr. Jerry Hayes: Will the hon. Gentleman give way?

Mr. Cook: No. I have already made a promise.
We have already damaged the health service. If, even before those hospitals become trusts, they no longer regard other hospitals as partners in the same public service but as commercial competitors—

Mr. Oppenheim: As I know that the hon. Gentleman will have carefully costed the Labour party's proposals for the NHS, will he say by exactly how much he believes the NHS to be underfunded? Will it be the priority of a future Labour Government—should one come to power—to redress that underfunding?

Mr. Cook: Yes, it will be a priority of the next Labour Government. The Labour party's Front Bench team all understand that that will be one of the key ways in which the next Labour Government will be tested.

Mr. Waldegrave: Will the hon. Gentleman give way?

Mr. Cook: I shall happily give way to the Secretary of State, but I am still replying to his hon. Friend the Member for Amber Valley (Mr. Oppenheim).

Mr. Waldegrave: For the aid of the Hansard writers, we heard the hon. Gentleman say "a priority". Will he now say, among all the other priorities, how much would be spent?

Mr. Cook: Both those questions are now of such antiquity that we should send them for carbon dating. Let me respond—[Interruption.] There is not much point in Conservative Members asking questions if they will not listen to answers.
I shall respond by stating quite plainly what we have said on funding. First, each year we shall ensure that, if we approve a pay award in the health service, we shall fully fund it in a way that the Government have never done since 1985. Secondly, when we produce our budget for the national health service, we shall fully take into account the pressures on the budget of the growing numbers of the very elderly in our community—the very people who created the NHS and who, cruelly, now find that they cannot use it when they need it. Thirdly, in the first year we shall start to tackle underfunding and shall continue to do so year on year.

Mr. Hayes: The hon. Gentleman really must come clean. Thousands of people saw him on the Jonathan Dimbleby progamme yesterday and saw Mr. Dimbleby ask the hon. Gentleman about the £4 billion of underfunding that the Leader of the Opposition talks about and the £6 billion underfunding that the British Medical Association talks about. The hon. Gentleman replied that he was not in a position to validate the estimates. How can anyone believe him?

Mr. Cook: The hon. Gentleman and I had the same exchange during the last debate, in which the hon. Gentleman accused me of not being serious because I said that it could not be done overnight. Having watched the Conservative party conference I understand that, for the hon. Gentleman, "overnight" is rather a long time. Nevertheless, the position remains precisely the same; over the lifetime of the Parliament, we shall seek to restore the underfunding, and in each year we shall make progress towards achieving that end. In precisely—[Interruption.]

Madam Deputy Speaker: Order. This is a most serious debate. Millions of people outside the House, as well as those inside it, are listening to the debate, so let us have it conducted in good order so it might be properly recorded so that they may understand it.

Mr. Cook: We shall do it next time because we did it last time. The last Labour Government—

Several Hon. Members: rose—

Mr. Cook: Conservative Members will have to listen to the facts now.
Inside five years, the last Labour Government provided more extra nurses and doctors for the NHS than the Government have done in more than 10 years. Every year, we increased the real resources to the health service by twice the amount that the Government have done. If Conservative Members are seriously going to contend that the—

Dr. Keith Hampson: On a point of order, Madam Deputy Speaker. There was a gross

inaccuracy in the hon. Gentleman's statement. The only time during the past 20 years when there was a real cut in NHS spending was in 1977.

Madam Deputy Speaker: That was not a point of order at all.

Mr. Cook: If Conservative Members are seriously going to contend that there is no underfunding of the health service, as appears to be the basis of their chant, let them try to tell that to Maria Mullhall. Let the Secretary of State try telling her about equal access to free health care. Last year, her father's heart operation was cancelled. This year, her father had a second heart attack.

Mr. Gale: On a point of order, Madam Deputy Speaker.

Mr. Cook: I can understand why Conservative Members do not want to hear this.

Madam Deputy Speaker: I shall take the point of order, which I hope is genuine.

Mr. Gale: Madam Deputy Speaker, a few moments ago I distinctly heard you say to Conservative Members that thousands of people outside the House were waiting to hear the answer to a question. Could you instruct the hon. Member for Livingston (Mr. Cook) to give it?

Mr. Cook: I can understand why Conservative Members do not want to hear about the real effect of their policies on real people. As the House well knows, the people outside the Chamber know the reality of what is going on in the health service, and they want to hear that reality expressed from the Opposition Dispatch Box during this debate. Conservative Members will not be allowed to silence that.
Maria Mullhall's father suffered a heart attack this year, having had his heart operation cancelled last year.

Mr. Ian Taylor: The hon. Gentleman is wriggling.

Mr. Cook: I am not wriggling. Conservative Members do not want to hear what is happening in the health service under their Administration.
Maria Mullhall rang 999 for an ambulance.

Mr. Patrick Nicholls: On a point of order, Madam Deputy Speaker. You reminded the House that the public would be watching this debate—

Madam Deputy Speaker: Order. I reminded the House that millions of people outside the House take this matter seriously, and the House should do likewise. We must hear this debate in the good order that this debating Chamber demands. I call Mr. Cook.

Mr. Nicholls: On a point of order, Madam Deputy Speaker.

Madam Deputy Speaker: Order. I have heard the hon. Gentleman's point of order and he must now resume his seat. I call Mr. Cook.

Mr. Cook: I very much hope that Maria Mullhall is one of those watching this debate, because she will see the depth of concern being expressed. When she rang for the ambulance, for 15 minutes she was connected to an answering machine asking her to hold. Her father died while she was connected to that answering machine. When


asked to comment on the matter, a spokesman for the ambulance service said that the answering machine was used "when demand is excessive".
How is it possible for a fatal heart attack to be described as an excessive demand? How can Conservative Members go on denying that there is underfunding when the system cannot handle an emergency call for a heart attack? There were no answering machines under Labour.

Mr. Waldegrave: May I remind the hon. Gentleman what happened to the emergency services when the Labour party was last in power? The Confederation of Health Service Employees was controlling access to hospitals and the ambulances could not get into the hospitals.

Mr. Cook: One of the reasons why people outside this House find it impossible to trust this Government's commitment to the health service is the open contempt with which they talk about most of the people who work in the service. One thinks of the contempt with which the Secretary of State quoted the Confederation of Health Service Employees at the Conservative party conference. He quoted the general secretary of COHSE as demanding that his members should
push for a health service that acts in the interests of its staff".
The Secretary of State got his applause at the party conference. It is a pity that he did not read what the general secretary of COHSE had actually written. He had called on his members
to push for a health service that acts in the interests of its staff and the people who rely on it.
What word can we use to describe that deliberate misquotation? What word will the Under-Secretary find in his well-thumbed Collins dictionary to describe it? How dare they accuse us of lying?
Maria Mulhall's experience was not unique. Dr. Michael Joy, a GP in Surrey, has done an analysis of his heart patients over the past 10 years and found that, in that period, 15 of them died on waiting lists for operations. None of them died while waiting for private operations.
It is difficult to do justice to the fury of the patients who write to us after being told that they will have to wait for more than a year for their operations and after learning that, if they had the money, they could have the same operation with the same surgeon in the same hospital in little more than a week. Patients call it privatisation when they see more private wings in NHS hospitals providing a fast track for patients who can pay. In Doncaster, the wards closed by the trust hospital are being reopened by an American private hospital company. In Newark, the proposal before the health authority is for 50 acute NHS beds and 50 private sector beds at a hospital designed from the start to have a first-class and a second-class compartment.
Patients call it privatisation when they find that geriatric wards are closed and patients are put in private nursing homes. How would Conservative Members who are seeking to intervene in this debate respond to the moving letter that appeared in a national newspaper last week from a man whose wife was admitted to hospital with terminal cancer and who described how his distress in her last months was increased by pressure to get her out of the NHS hospital and into a private nursing home? That took place in a hospital with 60 closed geriatric beds standing empty—a hospital that found the money and the land to

build a private wing for private patients. I can tell Conservative Members what this gentleman calls that. He says:
Not only is a form of privatisation taking place, it can be seen and it can also be experienced.

Mrs. Edwina Currie: Will the hon. Gentleman clarify what he has just said? Is it now Labour party policy to nationalise all the hundreds and thousands of first-class private residential care homes and nursing homes throughout the country and to put their occupants back, 30 or 40 to a ward, into NHS geriatric wards?

Mr. Cook: Of course that is not our policy. Our policy —this should be the duty of any Government charged with the management of the NHS—is to make sure that those patients have a choice between public and private sectors, and that they are not confronted with a private sector monopoly.
Patients call it privatisation when they discover that the dentist will treat them only if they go private. The day the Prime Minister made his speech on not privatising the health service, patients at a practice in Devon received a letter from their dentist telling them:
As from January 1992 we shall no longer be able to offer NHS treatment to our fee-paying adult patients.
The contrast between what the Prime Minister said and what they were told was so stark that three separate patients of the practice in question sent me the letter, saying:
It surely is privatisation by the back door.
Patients call it privatisation when they discover that they have to pay for what used to be free. I was extremely interested to hear the Secretary of State say yesterday that it was illegal to charge NHS patients. I was sorry to learn from this morning's papers, however, that, when asked, his Department could not find a single case in which he had intervened to stop such charging.
Scarborough health authority has sent a letter to those who used to receive incontinence aids:
You will be aware that, in a modern"—

Mr. Ivan Lawrence: Nonsense.

Mr. Cook: In that case, it is nonsense from health authorities acting under a Conservative Government.
You will be aware that, in a modern NHS, each health authority has to look carefully at costs and expenditure. After careful thought I have therefore decided that the free supply of incontinence aids can no longer be sustained.
So patients on income support find that they are being charged for incontinence aids that once were free.
What will the Secretary of State do about Bart's, where this morning it was discovered that some patients coming for fertility treatment are being asked to pay £350 of the £800 cost? Will the right hon. Gentleman stop that after this debate? What will he say to the woman in Ipswich who wrote to me because 12 years ago she injured her spine and was given a free appliance to help with the pain? She finds that this month she will have to pay £70 to replace the appliance. What will he say to this woman of 72, so poor that even under the present rules she qualifies for housing benefit? She says:
Yes, it is creeping privatisation of the NHS".
These are not our words: they are the words of the patients who know what is happening. Are they too lying when they describe what happens to them?

Mr. Devlin: Perhaps we could move a little further north, from Scarborough to Langbaurgh, where on


Thursday the Labour candidate said that hospitals that opt for self-governing status opt out of the national health service. On the same day, the hon. Member for Middlesbrough (Mr. Bell) said in the Evening Gazette that hospitals that become trusts remain part of the NHS. As the hon. Member for Middlesbrough is sitting in front of the Langbaurgh candidate's friend, perhaps the hon. Gentleman would like to introduce them?

Mr. Cook: The hon. Gentleman clearly came here with instructions to get his sound bite in for the local press. I was foolish enough to imagine that he was going to say something relevant to the debate—but I think it time that we made progress. People who find that their health service treatment is slipping away from under them will remember the total indifference that the hon. Member for Stockton, South (Mr. Devlin) showed on this point.
We shall not let the Secretary of State come back to this House after what he has said about charges being illegal without hearing whether, after this debate, he left the Chamber and stopped those charges.
Quite properly, Madam Deputy Speaker, you do not allow us to use the word "lie" of each other in this House, but the rules do not prevent me from reporting that the word has been used against me time and again in the past three weeks—although not in this Chamber. It has not been used to my face, when I am in a studio—it is always said when I am not there to answer back. No one has raised the charge more often than the Secretary of State, whose routine response to criticism now is to brand it a lie.
The reason for the Chamber not allowing the use of the word "lie" is well-founded: it is that we cheapen and degrade public debate when we reduce it to the level of personal abuse. The politician who forgets those rules will pay a high price. It is a price that is exacted by a public who will treat with contempt any politician who would rather abuse his opponent than answer the charges. After a fortnight of abuse by Conservative Members, the voice of the nation was heard last weekend, in a poll which gave health as the largest single reason why people would not vote for this Government.
The Secretary of State had some fun at the expense of our policies. He has clearly been through our document "Fresh Start for Health". It is the fullest, longest, most comprehensive health document ever produced by an Opposition. Before coming to the debate, I went to the Oriel room and requested the documents that the Conservative party produced on health policy before the 1979 election. I was told that none could be found.
So that the Secretary of State has no doubt about our policies and why the public prefer them, I shall tell the House what our policies are. First, we shall rebuild the NHS as a public service and bring back into the local health service those hospitals that have gone it alone as trusts. We shall not bring them back into health authorities that represent just the Secretary of State of the day, but into health authorities that represent local communities. We shall set each of them a performance agreement which will tackle the variation in performance which Conservative Members keep identifying and never tackle.
We shall offer pressure and incentives to improve the performance of health authorities that are failing in public service while Conservative Members offer only the risk of

downsizing and closure in a health market. We call our document "Fresh Start for Health" because Conservatives have imposed on the health service a wrong agenda with the wrong priorities. That was plainly demonstrated last year, when the Government discovered that they could not afford their changes to the national health service and to community care and therefore chose to plough ahead with their unpopular changes to the NHS but to delay changes in community care until 1993.
It is not care in the community to take patients out of a geriatric ward and put them in a private nursing home. That is simply transfer from a public institution to a private institution. Real care in the community is provided by those local authorities which supply the home help service, the authorities that are in the top 20 in the league of home help provision—every single one of them a Labour authority. That is why we shall introduce a community care grant to support the work of those local authorities. We shall ring-fence that grant to make sure that the bottom 20 authorities, none of which are Labour, have to spend that money on the care of the elderly.
We shall create a level playing field in residential care to end the nonsense by which the biggest subsidy from central Government goes not into public residential care but into private residential care. We shall take the action that the Government have failed to take to make a reality of their targets in health promotion, such as banning tobacco advertising to stop pressure on young people to take up the habit and bringing in random breath testing to stop alcohol abuse. We shall undo the criminal damage that the Government did to the screening service when they introduced charges for eye tests. We shall restore the free eye test so that no one will have to go without an eye test because he cannot afford it.
We shall plug the biggest gap in the Government's list of health targets by introducing targets to reduce inequalities in health between income levels. Conservatives cannot do that, because they have spent a decade levering open inequalities in income and cannot now admit that they have also widened inequalities in health. We can improve matters, because we understand that people who are poor will suffer from poor health. We know that, when people are unemployed and cannot afford decent food, their children will grow up stunted; that, if pensioners cannot afford to heat their homes, they are more likely to die in winter.
We recognise poverty as a health issue, which is one of the reasons for our intention to end poverty wages through a minimum wage. We cannot stomach the double standards of an Administration who tell us that £3·40 is not too much for a prescription charge but is far too much to ask as a minimum wage for an hour's work. We shall do these things because we believe in policies that would enable us to live in a society that would rather invest in a modern health service than take tax cuts and run.
People outside also want to live in that society. They want the health policies that recognise that we can get better protection for everybody if we all work together to build a public health service that defends everybody rather than one that tries to protect private individuals. That is why health is now one of the largest of the major issues registered in all the opinion polls. It is also why health is now the largest single reason why people are so anxious to sweep this Government out of the way.

Sir Norman Fowler: At the start of his speech, the hon. Member for Livingston (Mr. Cook) dealt with waiting lists and patient care. I agree that those issues are the test, but he should remember what happened when Labour was in power and was able to implement some of its policies. Under Labour, nurses' pay did not increase, it fell behind. The hon. Gentleman spoke about rebuilding the national health service, but when Labour was in government capital spending fell by 29 per cent. Spending on hospitals has never been cut as it was by the last Labour Government, who left the hospital building programme in total chaos.
People will have no confidence whatever in the speech by the hon. Member for Livingston, because it amounted simply to generalisations and at no stage did he set out how much he intended to spend on the health service. Over the past 15 years, the actions that caused most harm to health care had nothing to do with trust hospitals, contracting out or health charges. They were the industrial action that brought the 1979 winter of discontent and the health strike of 1982. That action lengthened the waiting lists and prevented patients from being treated. In 1979, the Labour Government did nothing to prevent the damage and in 1982 Labour supported the industrial

Mr. Harry Ewing: As a former Secretary of State, the right hon. Gentleman knows that the hospital building programme is a long-term project. When the Labour Government came to power in 1974, I found, as Health Minister at the Scottish Office, that there was no hospital building programme to inherit from the outgoing Tory Government. It took us some time to get into place a decent hospital building programme.

Sir Norman Fowler: I have great respect for the hon. Gentleman, but I do not accept that as the historical position. It is well set out in every objective history of that period that the Labour Government got into such devastating trouble with their economic policies that they had to cut every capital building programme, including that for hospitals. That is why the Labour Government were so disastrous for social services.
If predictions are required, mine is that the greatest danger for the future of health care—that is, services for the patient—is a Labour Government who are still in hock to the big public service unions. We have already seen the process in operation. Mr. Bickerstaffe has told Labour Front-Bench spokesmen that his members do not want any contracting out or competitive tendering. Without any discussion or argument, the hon. Member for Livingston has given an assurance on that to the unions. He would throw away, if he were in government, £50 million of income to the NHS.
There is no point in talking about underfunding of the health service when a shadow Secretary of State is prepared to agree to such demands. Those who are interested in health care should be concerned about that position because there is no point in giving the health service extra resources if those resources, rather than being devoted to patient care, are used to buy union support. Mr. Bickerstaffe clearly regards Labour Front-Bench spokesmen as soft touches, as pushovers.
The hon. Member for Livingston once again raised the issue of privatisation, but, in an effective speech, my right hon. Friend the Secretary of State thoroughly and ably

demolished those claims. This is not the first time that the privatisation issue has been raised. It was raised in the 1979, 1983 and 1987 elections. Not long before the 1983 election, I published a short document, called "Co-operation between the NHS and the private sector at district level", aimed at achieving sensible co-operation, for the benefit of patients, between the health service and the private sector.
I am glad to see the right hon. Member for Blaenau Gwent (Mr. Foot) here because, as Leader of the Opposition at the time, he described this as the most serious attack on the national health service since it was started. I am glad also to see the hon. Member for Crewe and Nantwich (Mrs. Dunwoody) here. She said that we were secretly dismantling the health service.
Those statements sum up the attitude that the Labour party has displayed on health service policies over the past decade. It is not interested in any co-operation between the health service, the private sector and the voluntary sector. All we have is this sterile, barren knocking match between the two sides.
The privatisation claim should be seen for what it is. It has no substance. It is but an electoral card. The only difference is that this time the card is being played even before the election campaign has started. It has achieved the unlikely result of making the hon. Member for Oldham, West (Mr. Meacher) appear to be a master strategist. However, my right hon. Friend the Secretary of State is correct. The Labour party has already abandoned its central claim of privatisation, which must mean the organisation on the health service on private insurance lines.
The Labour party has a new claim—that of creeping privatisation—the basis of which must be a policy of national health charges. That is a curious accusation, because it was not a Conservative Government who introduced prescription charges, eye test charges and dental charges, but a Labour Government. One could construct a theory that Mr. Attlee and Mr. Gaitskell stand revealed as closet privatisers, but it is much more likely that the first post-war Labour Government faced the problem that has characterised the health service ever since —an increase in costs led by an increase in demand and therefore a need not only to raise resources but to use those resources to maximum effect for the benefit of patients.

Mr. Robert Litherland: Will the right hon. Gentleman give way?

Sir Norman Fowler: No, I shall not, because I do not wish to take up much time.
That is why so much of the Opposition case today and so much of the case that they set out in the country is so barren. There is no doubt that over the next year, the cost of the health service will increase because of an aging population and medical advances. Thus, the aim of the Government, of whatever political complexion, must be to achieve, through good management of the service, the maximum impact on health care.

Mr. Robin Corbett: Will the right hon. Gentleman give way?

Sir Norman Fowler: I have already said that I shall not give way.
What trust hospitals are all about is devolution downwards. It is what any decently run company or


corporation would do. I speak with at least some experience when I say that it cannot make any sense for all the decisions in a service of about 1 million people to be made by the Secretary of State at the centre. If Labour Front-Bench spokesmen do not understand that, they understand nothing about the NHS.
The Opposition oppose this policy, as they have opposed other changes. After the report from Roy Griffiths, I introduced general managers, to which they were opposed, despite the fact that there was no mechanism for making effective decisions. Today, they accept general managers and will not abolish them, despite two years opposing such a policy.
I remember that they opposed the selected list of drugs. As many of my hon. Friends will remember, they pressed me to make economies in the drugs budget, but when I tried to do so, they showed their great constructiveness by opposing my measures. If they ever come to government, they will not reverse that policy. Not even the hon. Member for Peckham (Ms. Harman) would put all those drugs back on prescription.
The Opposition have a great deal to be modest about in respect of their record in opposition. They have now announced their blanket opposition to competitive tendering in ancillary services such as catering and cleaning. There is no question but that that throws away resources, but the principle is that it is often more effective for a specialist company rather than an in-house organisation to do work such as catering and cleaning. There is nothing especially revolutionary about that—it is not even a matter of the public sector versus the private sector. Managers in all types of organisations have the option—sometimes they use it and sometimes they do not.
If the Labour party were in power, that option would be abolished, and that shows a good deal about the party. It shows what I can describe only as an antipathy towards outside industry, an antipathy which shifts only when the Labour party puts down a motion that deplores or regrets the decline in industry itself. However, above all, it shows an antipathy to good and effective management inside the health service, and that is what I regret most profoundly. Labour has no experience of management. That is not necessarily a criticism, but it is a criticism when I say that Labour shows no interest in good management.
The Government are right to aim for a better-managed health service and one in which the patients' interests are dominant rather than the interests of the providers. Labour's approach may scare some voters—I accept that it could easily do so—and I suppose it is possible that its approach may win a few votes. Personally, I should rather lose a few votes and do what I believe is right in this respect. In fact, I do not believe that the Government will lose votes on their health policy, because the Opposition have started their scare far too early. They are already being rumbled, as my right hon. Friend the Secretary of State showed in his brilliant speech, and by the last act, they will be revealed as bankrupt of policies. Basically, they stand for nothing but the interests of the big public service unions. We respect the legitimate interests of all those who work in the health service, but, above all, we stand for better patient care. I believe that we have the courage to pursue policies that will achieve better public health care.

Mr. Charles Kennedy: The debate on the future of the health service—especially that between the Secretary of State and his opposite number in the Labour party, the hon. Member for Livingston (Mr. Cook)—has become or has begun to resemble a cross between All Souls college and the All Saints road. This afternoon's debate is scarcely an exception. Somewhere in the middle of the claims and the counter-claims, of the inflated and exaggerated allegations from both parties, is the national health service. It is undoubtedly true that it is underfunded, that it suffers from low staff morale, that it is increasingly becoming a political football and that, on the basis of this afternoon's evidence, it is likely to remain so.
The Select Committee on Health could serve as a useful barometer. On occasions, despite its all-party nature, it has been able—as the right hon. Member for Sutton Coldfield (Sir N. Fowler) and the present Secretary of State surely know—to produce unanimous reports on many conten-tious, difficult and complex health issues. Sadly, that ability appears to be lacking in the Chamber, and the Government's reforms continue apace. That must partly be due to the way in which the Government went about their reforms.
Had the previous Prime Minister bowed out the leadership of the Conservative party after, say, a decade in office, one doubts that the reforms would have been introduced in the way that they have been, that the pace would have been accelerated as it has been or that they would have seen the light of day in their current form. I cannot envisage the current Prime Minister or the Secretary of State going about the reforms in the way that they are now obliged to do. They are living out the legacy left to them late in a Parliament and very late in the day for the Government.
When one considers that legacy and the about-turn in one aspect of policy which the Secretary of State mentioned on television yesterday—in respect of tax incentives foisted on the Cabinet and contained in the Budget two years ago against the wishes of the then Secretary of State for Health, the Chancellor and many others—one must ask, in view of the number of people in general management who are now on performance-related contracts in the health service, what return a Secretary of State and his Cabinet colleagues would enjoy in terms of performance-related ability for such about-turns in respect of the public purse within only 24 calendar months.
The Government decided to press ahead with the first tranche of trusts despite all the warnings. Last week, we heard about the second tranche of trusts despite the lack of democracy, the lack of consultation and the lack of public and professional consent. Mao Tse-tung was once asked what he thought of the French revolution. He sat back for a moment and then said, "It is too early to say." The same cannot be said about the NHS trusts. It is by no means too early to come to a conclusion about them. In the absence of pilot schemes the trusts have been a crazy way of going about reforms. The national health service—

Sir Jim Spicer: Will the hon. Gentleman give way?

Mr. Kennedy: Of course I shall give way to the hon. Gentleman in a moment.
Earlier this year, before we moved into the second wave of trusts and before the first wave had begun to hit serious problems, the Secretary of State made it categorically clear in the House and outside that in future Ministers would no longer have to take key decisions in the way they did at that time about which hospitals would go and which would stay. If hospitals were inefficient, if there was over-provision or if they could not provide the right type of care or treatment, they would wither on the vine under the new commercial internal market system.
But what did the Secretary of State say last week when phase two of the internal market system was announced? His statement contradicted the philosophy behind the Government's approach. Announcing the delay until April 1993 of the date on which the four London teaching hospitals would become operational trusts, he said:
I have asked the NHS management executive to establish devolved management in these hospitals at the same time as the other trust boards are established. In this way, these four great hospitals will get as early as possible the benefits of devolved management."—[Official Report, 16 October 1991; Vol. 196, c.312.]
We would not be against the benefits of devolved management. It makes sense to suggest that public money can be used more efficiently nearer the point where the care must be delivered. That points to greater devolution within the hospital sector of the health service, but the Secretary of State's statement contradicted the thinking behind the reforms. It makes it clear that one can have the devolved management structure without having to go the whole way towards NHS trust status. The Secretary of State admitted that contradiction in his concession last week.

Sir Jim Spicer: The main thrust of what the hon. Gentleman is saying is that we need to establish a track record on the trusts. I come from West Dorset, where three trusts have been established. We are side by side with the Yeovil district hospital, which is a trust. The hon. Gentleman talks about low staff morale, but in the five months since that trust has been established, staff morale is sky high and its record of achievement—alongside that of West Dorset —is remarkable. Perhaps he has discussed the issue with the leader of his party, but would it not be more politic for the leader to say that he has a good example on his own doorstep and that he would be wholly in favour of the policy if the same progress could be established as is seen in Yeovil hospital?

Mr. Kennedy: That is not the account that I received from the leader of my party. On his recent visit to that hospital he was concerned, as the local Member of Parliament, about the anxieties expressed to him by people in the hospital about the future funding basis. They were precisely the anxieties that have arisen about so many other trusts because of the uncertainty into which they are entering.
The hon. Member for Dorset, West (Sir J. Spicer) will appreciate that I am not in a position to bandy statistics with him about his part of the country, and I suspect that he does not want to give an in-depth account of health service provision on the north end of Skye. I will say to the hon. Gentleman that any step into the unknown, which for so many units—different sector hospitals in particular— trust status involves, is bound to bring with it apprehension, which my right hon. Friend the Member for Yeovil (Mr. Ashdown) has reported to me. However, I

shall draw the hon. Gentleman's remarks to the attention of my right hon. Friend, and I am sure that he will be interested in what the hon. Gentleman has to say.
The hon. Member for Dorset, West has raised an important point. Surely it makes more sense, if one is to deliver more devolved management and more efficient use of public money within the hospital sector, to be more decentralist in one's approach to the management of the health service. By definition, in going down the hospital trust route, which they claim in part is about decentralisation and greater local autonomy, the Government do not follow the logic of the argument.
Local people are not enjoying a local say either in the decisions about trusts or in their subsequent operation. That has been seen over the past decade in the way in which health authority membership has been twisted again and again by the Government so that the prime qualification has become not knowledge of the health service or commitment to the area in which the health care is delivered, but first and most importantly: "Is this individual a card-carrying member of the Conservative party?" That makes people cynical about the changes they now see.
The cynicism has been heightened with the trusts because all too often the board, the company and the directors established and appointed do not have a tremendous—or any, in some cases—track record of experience of the health service, and do not have a local community identification in the area in which the trust will operate.
The Secretary of State announced last week, in the absence of any pilot scheme and now with only one specific, important and necessary independent inquiry into the health service in London, that he is pushing ahead. Why, if he can freeze the four teaching hospital applications, can he not apply the same principle further afield and freeze the second wave of trust applications? Indeed, he could go further and cancel them, and extend the London inquiry to a national basis. In the meantime, he should not pursue further any opt-outs in Scotland or in Wales.
Looking at the memoirs of the right hon. Member for Worcester (Mr. Walker), the former Secretary of State for Wales, it was interesting to see his account of the time when trust status was first being discussed within the ranks of the Cabinet. He was allowed by the then Prime Minister, as he interestingly reveals in the memoirs, to treat Wales as a laboratory for his far more Keynesian approach to politics generally, rather than for the Thatcherite economics which was the order of the day. He concluded simply that NHS trust status would not be a relevant factor for Welsh health care delivery. That was not so in Scotland.
In the context of the all-important Kincardine and Deeside by-election, we have what the Minister of State, Scottish Office wants to hold up as the flagship NHS trust application for Scotland—the Foresterhill complex in Aberdeen. That flagship is more likely to prove an electoral Titanic for the Scottish Conservative party. In the context of the Grampian area and of Aberdeen in particular, there is no scope for any meaningful competition for Foresterhill.
The Foresterhill application effectively involves the confiscation of land from the university of Aberdeen, which has joint ownership of the site. If the hospital were to pay the university at the market rate, it would saddle the
trust with so much capital debt that it would render the business plan meaningless, and the trust would be bankrupt even before it had been set up. Perhaps the Secretary of State will compensate the university for the loss of the site. However, that would be a blatant misuse of public funds for politically doctrinaire ends.
It would be utterly absurd for the same person to decide what level of compensation the university would receive for the loss of facilities, if the trust application went ahead, and to sit in judgment on the trust application itself. It would be a classic conflict of interest. It would not be allowed in the council chamber, and it should not be allowed in the Cabinet. That alone should render the entire application for the Foresterhill opt-out null and void forthwith. If the Government are not willing to give that message at the end of the debate tonight, they will get that message from the public in the by-election on 7 November.
What about the existing trusts which have already gone ahead in England? They should be reviewed case by case, given the remarkable financial holes which have opened up among many of them. Their financial viability, the community responsiveness and the extent to which they can be brought back under the health authority's ambit should all be guiding principles here. The membership of the trusts, and the whole question of the extent to which the buildings and the sites involved can be brought back directly into NHS public ownership, are also relevant.
It is not enough to look at the existing tranche of trusts, as the Labour party proposes to do, and to say that, on the appointed hour, all the gears will be thrown into reverse and there will be a further reorganisation in the other direction. I can assure the House that anyone talking to professionals in the health service knows that they are sickened by reorganisation after reorganisation, and that morale would be further depressed by that. A more pragmatic approach will have to be taken to the first wave of trusts.

Mr. Robert Hughes: The hon. Gentleman is on an interesting point, especially in relation to the Foresterhill hospitals. Is he saying that, if the Secretary of State for Scotland agrees to the opting out of Foresterhill, matters should be left there, and that the health of the people in my constituency should be left to the vagaries of the trust? The hon. Gentleman cannot have it both ways. He is either for the trusts or against them. He cannot hedge any more in Kincardine and Deeside.

Mr. Kennedy: There is no hedging going on in Kincardine and Deeside, or anywhere else, as the hon. Gentleman knows. The Liberal Democrat candidate in Kincardine and Deeside has organised a massive petition for many months before the by-election on the issue. I have just made the position clear. In Wales and in Scotland, there should be no opt-outs, full stop, because they are not there already. In England, there should be a complete cancellation of the second wave of proposed opt-outs.
For the first wave opt-outs which have already gone ahead, the presupposition must be against the continuance of NHS trusts, which means studying the membership of the trusts and the statutes under which the trusts have been established, including the ownership of the sites and of the land, the conditions of service of the staff, the contracts of employment and the lack of democracy that has bedeviled

the entire process, to ensure that the national erosion of the health service does not go further. That is a clear and unequivocal statement of position.

Mr. Jim Sillars: Let us consider the position in Scotland. If the Tory Government ignore public opinion in Kincardine and Deeside and, let us say, in Ayr, where the Ayr district general hospital is also a candidate for trust status, will the Liberal democrats wish those hospitals not to be transferred back into the national health service?

Mr. Kennedy: No.

Mr. Sillars: The hon. Gentleman says no. Why should it be different in England?

Mr. Kennedy: With great respect to the hon. Member for Glasgow, Govan (Mr. Sillars), I must point out that I have said no such thing. The smile on the hon. Gentleman's face suggests that he knows that. I have made the position clear. In Committee and in the House, the Liberal Democrats opposed NHS trust status, and we continue to do so. I am talking about the first wave that have been approved in England. They are already up and running. The question that has to be addressed is how, in practical terms, they can be brought back under proper national health service management control. Practical legislative means are available to the Department of Health, and we argue that such means should be used. That position is clear.

Mr. Bob Cryer: rose—

Mr. Kennedy: I want to continue.
The great financial difficulty into which the Government have got themselves into is that they have confused cross-boundary flows with an internal market. That has now been seen by the health authorities that are losing in terms of extra-contractual referrals. Indeed, halfway through the financial year, some health authorities find that the money that was set aside for extra-contractual referrals has been almost used up. So much for money following the patient; the patient is now following the money, due to the nature of the block contracts which have been entered into. They reduce GP and patient choice, and make nonsense of the so-called citizens charter—let alone any patients charter.
What, then, should be done about NHS funding? First, the Government have never properly recognised that the true level of health service inflation runs persistently higher than that expressed by the retail price index. The opinions of experts differ, but I think that it is fair to say that the difference is between 1 per cent. and 2 per cent.
That being the case, surely it is essential for the Government to increase annual expenditure on the health service by a minimum of 1 per cent., in real terms, above the level of health service inflation. If they are committed to growth in the service, that will be necessary not only to keep pace with developments in medical technology and with the demographic change that has increased the proportion of elderly people, but to advance.
Secondly, within that total the Government must include the abolition of charges for eye and dental tests. There is no doubt that, in the long term, the disincentive that those charges produce will cost the country more. People will choose not to use the excellent preventive services that are now available.

Mr. James Couchman: Is the hon. Gentleman aware that the number of eye tests currently being carried out has risen almost to pre-charge level?

Mr. Kennedy: I am afraid that the hon. Gentleman is very badly informed. An analysis that we have conducted over the past 12 months, which covered several hundred constituencies, proved conclusively that, in the case of opticians, the opposite is the case.
Any dentist or optician will tell the hon. Gentleman that there are now two income categories that they can treat, providing the full range of preventive and promotional health services that they wish to provide. The first category comprises people on income support, whose treatment has been fully funded; the second comprises those who are sufficiently well off not to have to worry about the cost. Those who fall between the two categories —who now form the majority—are having to cut corners, and are not proceeding with the full-scale preventive treatment that is considered essential. The hon. Member for Gillingham (Mr. Couchman) is, quite simply, wrong.
The Labour party says—I do not doubt the sincerity of its intent—that it would make extra finance available as economic growth was achieved. We should, I think, view the position with a little more optimism: we should take the view that, in the event of 1 per cent. real growth on top of health service inflation, any economic growth on the basis of which further NHS funds could be provided should be seen as a health dividend—as a means of bringing Britain, bit by bit, more into line with our continental neighbours in terms of the proportion of GDP that we devote to health.

Mr. Rowe: Will the hon. Gentleman give way?

Mr. Kennedy: In fairness to Conservative Members, I want to finish my speech soon.
Thirdly, the Government must be prepared, if necessary, to use contingency reserves for the full funding of national pay awards. We must end the ludicrous and unfair system whereby awards that are decided centrally are not funded nationally, necessitating the making of local cuts. Our approach is honest, in that it recognises the need for those who criticise the Government for not spending enough to spell out the details of the additional expenditure that they themselves advocate. I sympathise with some Conservative Members, who must feel irritated when they hear complaints from Opposition Members who give no pledges or figures to back up those complaints. That is not the stance that we have taken; we have already made our costing public.
Trusts currently dominate the health debate, and I noticed that the word "trust" also dominated the conference address of the Conservative party chairman, who almost invoked Baldwin by saying, "Trust the people." The people do not trust the Government with the health service, and they certainly do not trust what the Government are telling them about the health service and hospital trusts.
The result of the Eastbourne by-election contributed somewhat, I believe, to the atmosphere that led to the downfall of the right hon. Member for Finchley (Mrs. Thatcher); the Ribble Valley result contributed somewhat to the circumstances that led to the withdrawal of the poll tax. I think that an appropriate result in the Kincardine and Deeside by-election—appropriate from our point of

view, and that of the health service—could contribute to an end to further opt-outs, and a reversal of the policy itself.
The Government's reforms are as misconceived as the present Secretary of State for Health is miscast. There is a case for a realistic costed alternative; the Liberal Democrats will continue to argue in favour of it in the House, on the hustings and whenever the opportunity provides itself.

Mr. Michael Morris: First, I declare an interest: I am married to a general practitioner, and I am an adviser to two pharmaceutical companies.
This evening marks the first occasion on which I shall have voted with the Government on the national health service issue since the introduction of the GP contracts and the NHS reforms. I shall be doing so because it is now clear to me that the present Prime Minister is 110 per cent. committed to the national health service. He has made it abundantly plain to the nation not only that he believes in the service, but that he has used it throughout his life, and that his children were born into it. That commitment represents a gold standard that the public should understand and respect, and I think that they do.
My right hon. Friend the Secretary of State has shown doggedness and tenacity in achieving a real increase in funds for the national health service. That is long overdue, and I pay tribute to him. Those of us who were here at the time of the 1974 Labour Government remember all too clearly the cuts that were made then; perhaps the hon. Member for Livingston (Mr. Cook) was not here, but if he was, he must remember the debates that took place—I spoke in some of them. In particular, he must remember the 3 per cent. cut in nurses' pay, the 17 per cent. cut in doctors' pay and the 29 per cent. cut in capital expenditure on hospitals. I must tell the hon. Gentleman that that record does not stand up against the record achieved by the current Secretary of State.
Having conferred those words of praise on Ministers, I do not wish them to think that I am entirely satisfied with what is happening on the ground. I want to ask them some questions. First, are they really doing enough to chase the NHS executive up hill and down dale to implement the reforms? Let us look briefly at the role of the GPs as gatekeepers for a successful hospital service.
There is little doubt that the concept of fund holding —the concept, in effect, of the self-employed general practitioner—is attractive, and GPs will wish to continue in that role. Having read the medical press and listened to the views of many doctors all over the country, I am convinced that there is a general desire to adopt such arrangements. I hope that the artificial restriction in respect of the number of patients will be removed. There are GPs in my constituency who are under that level, but they are perfectly capable of becoming fund-holders if they so wish, although there is no compulsion.
Morale remains too low among our GPs. A letter about GPs' pay arrived this morning from the general medical services committee. It stated that targets have been achieved under the contract, but that it is the review body's desire to claw back the extra remuneration achieved by meeting those targets. If my right hon. Friend the Secretary of State wants to switch off every GP in the


country, there is no surer way to do that than to ensure that, if a GP meets his target, the extra money that he earns will be clawed back for achieving the target.
My hon. Friend the Under-Secretary of State for Health issued an excellent press release on 18 October about the increase in the number of GPs using computers. That was a good press release, but it would carry more weight if there were not family health service authorities around the country which were unaware of their budget until this year was five months on and which have said that there will be no remuneration for maintenance payments. Even today, funds available for GP computerisation are inadequate to meet the targets that my hon. Friend the Under-Secretary of State wishes to achieve.
One of the problems is how to tackle the FHSAs. We must stop some of the nonsense that is occurring. The exceptional FHSAs, which do something other than the norm, cause the trouble. In some cases, authorities will transfer resources from one budget to another, and that distorts general practice in that area. In other cases, money set aside for staff and premises is transhipped to another category of expenditure. There are GPs in some parts of the country—thankfully, not in my constituency—who are not being paid the full amount for what they achieved in the previous quarter. If my right hon. Friend the Secretary of State reflects on the GP contract, he must realise that it was probably a mistake to have only one medical representative or doctor on FHSAs. The experience of those dedicated people is necessary to make the system run smoothly.
Trust hospitals are, and always were, part of the national health service. They are part of devolved management, which was the concept behind trust status. The problem, as many of us who have studied these matters know, is that the strategy of my right hon. Friend's predecessor, the former Secretary of State for Health, to rush in with 57 new trusts without clear monitoring has proved to be a sticking point.
I agree with the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) that it makes no sense to proceed without a thorough analysis of what those 57 hospitals have achieved. If the vast majority are a success, we can go forward with total confidence. I believe that that may be the case, but I should like it confirmed.
With regard to the second wave, I considered the applications for the Oxford region, part of which I represent, and I was happy to support the majority of those applications. However, I thought that the submission by the Milton Keynes acute hospital was distinctly thin. That unit has not managed to live within its budget since it was created and it has been feather-bedded because it is a brand new city hospital for the new town of Milton Keynes. Nevertheless, its application was approved. Decisions of that kind cause difficulties.
Northampton general hospital has not sought trust status yet, but what safeguards will apply to that hospital if the hospital in Milton Keynes faces difficulties? Will Milton Keynes once again receive the extra resources to the detriment of the remaining hospitals in the Oxford region? If devolved management is the basis of the development of the hospital side of the NHS, we should remember that there are two forms of devolved management in education—grant-maintained status and

local management status. Although trust status may be one form of devolved management in the health service, one hopes that there may also be others—this should not be a black or white issue.
I fervently believe that it the right of every patient—and, through the patient, the GP—to know how long he or she will have to wait. I congratulate my right hon. Friend the Secretary of State on setting firm targets, so that, by next March, no one will be on a waiting list for more than two years, and that, by March 1993, no one will be on a waiting list for more than one year. Both those targets are praiseworthy. However, it is not sufficient simply to consider in-patient waiting lists; we must also consider the delays in obtaining out-patient appointments. We must highlight that dimension as well.
The changes will not occur simply as a result of exhortations from the chief executive of the NHS. There must be a combination of relentless pressure for continuous quality improvement similar to that achieved by the quality control methodology of manufacturing industry. It also requires extra targeted resources. Why can we not have a monthly statement to show what we are achieving in comparison with our targets? All hon. Members receive a monthly statement about unemploy-ment which is broken down to constituency and ward levels. If we can have such a service from one section of the state, why can we not have such information about the NHS?
The basic position of my right hon. Friend the Prime Minister is crystal clear. Whatever may have been the intentions of my right hon. Friend the Member for Finchley (Mrs. Thatcher), it is clear that the present—and, I believe, the future—Prime Minister uses the NHS; he believes in it, and he is grateful for what it has done for him and his family. The basic concept of its being free at the point of use is fundamental to him, to me and to all Conservatives. The other significant change is that my right hon. Friend the Prime Minister recognises that the NHS requires extra real resources. However efficient the management may be—there is still a long way to go in that respect—we cannot hide the fact that the NHS's percentage of GNP must rise in this country. We should not be on a level with Greece and far below France, Germany, Italy and our other European partners in that regard. My right hon. Friend the Prime Minister recognises that.
Labour never got the economy moving. Labour Members have never been able to achieve what they wanted in their hearts to achieve. Their desires remained desires and aspirations, never becoming a reality.
I remain critical of what is happening on the ground and of the way in which some of the strategies are interpreted at district health authority and FHSA level, but for the first time I can honestly say that we have a Prime Minister and a Secretary of State for Health who believe in a national health service. I shall therefore have pleasure in supporting the Government today.

Several Hon. Members: rose—

Mr. Deputy Speaker (Sir Paul Dean): I remind the House that the 10-minute limit on speeches operates from 7 pm.

Mr. Michael Foot: I am the only Member who was present in the House to hear Aneurin Bevan make his Second Reading speech which introduced the national health service and also heard him, from the same Bench on which the hon. Member for Northampton, South (Mr. Morris) sits, deliver his resignation speech about charges that were imposed. I was hoping to have discussed some of that history, especially because the Secretary of State gave a most misleading account of it. He should not have done that. He should have taken a bit more notice. He might even have learnt something from a letter which appeared in The Independent the other day, which states:
Sir: I am absolutely thrilled by William Waldegrave's undertaking for a complete reversal of Conservative policy on the NHS, that is, 'equal access to free health care throughout the country for everybody, regardless of their means'. My last two sessions of 'free' health care cost £52 (teeth) and £176 (eyes).
Aneurin Bevan would have been especially interested in that letter. It was on precisely the charges that were introduced for teeth and spectacles that he resigned. He had some other excellent reasons for his resignation, but he tried to give a warning to the country, a warning to the Labour party, which was on the Government side of the House at that time, and a warning to some others, too. The whole country would have been wise to listen to what he said. He said:
The Chancellor of the Exchequer in this year's Budget proposes to reduce the Health expenditure by £13 millon— only £13 million out of £4,000 million.
He went on to state:
hat is to be squeezed out next year? Is it the upper half? When that has been squeezed out and the same principle holds good, what do you squeeze out the year after? Prescriptions? Hospital charges? Where do you stop? I have been accused of having agreed to a charge on prescriptions. That shows the danger of compromise. Because if it is pleaded against me that I agreed to the modification of the Health Service, then what will be pleaded against my right hon. Friends next year, and indeed what answer will they have if the vandals opposite come in?
He was referring to the Opposition. He went on to state:
What answer? The Health Service will be like Lavinia —all the limbs cut off and eventually her tongue cut out, too." —[Official Report, 23 April 1951, Vol. 487, c. 41–42.]
Many of us think that Aneurin Bevan had great prescience. I do not think that he foresaw the way in which the present Government would seek to impair the rights of people in the health service to raise their voices against the methods that were forced on them by the Government. He made a careful prophecy, and I hope that everyone will take account of it. The Secretary of State was wrong in his history of the subject, so I advise him to read the excellent history of the national health service by Charles Webster. Many of the problems that the health service had to face are set out.
The Times Literary Supplementreview of that
publication states:
The miracle of the British National Health Service is not that it survived its delicate infancy but that it ever came to be horn.
Then comes the prophecy:
If it required a politician with the weight of an Aneurin Bevan to create the NHS, it will probably require one in the mould of Margaret Thatcher to dismember it.
The word "dismember" may be just as good as "privatise" because it means pretty well the same thing. It means

exactly what my right hon. Friend the Leader of the Opposition and my party have been describing to the country that the Government seek to do.
We can review the history of this measure as well as the history of what happened in the days of the Labour Government and the way in which we introduced the national health service and fought for it against all the opposition raised from Conservatives all over the country. There has been a history of this measure. The hon. Member for Northampton, South has made many brave speeches criticising the Government on the subject of the health service. He has much more knowledge of the health service than most of the rest of his party rolled together. They should take note of what he says. On previous occasions he has been even more critical. He now says, "It is different. The policy that is now being pursued by the new Prime Minister is different from the one that was introduced by my right hon. Friend the Member for Finchley (Mrs. Thatcher) when she was Prime Minister."
We must be fair to the right hon. Member for Finchley. It may seem very strange for an Opposition Member to say that, but we should be fair even to her. She was responsible for the introduction of the measure. She was responsible for refusing to listen to the doctors, the British Medical Association and the royal colleges. She is the one who slammed the door in their faces and would not listen to them. It is most unfair that all the blame should be put upon her. She was much too impatient, but she had Ministers who were much too subservient. She was always hectoring and they were always cringing. She knew what she wanted to achieve; they knew they wanted to hang on to their jobs.
If anybody questions what I say, he or she has only to imagine what would have happened if any Secretary of State for Health—heaven knows, there are plenty of former Secretaries of State for Health on the Government side of the House—had dared to have the latter-day conversion which afflicted the right hon. Member for Henley (Mr. Heseltine). He belatedly decided that he would oppose the poll tax, even though he was quite prepared for the poor Scots to endure it. But he at least revolted. If one Secretary of State or one member of the Cabinet had dared to revolt, the Government would not have led us down that dangerous path which threatened the future of the national health service.
Ever since the new Prime Minister took his job—an Edmund Burke phrase rings in my mind—his Ministers have attempted meanly to sneak out of difficulties into which once they proudly strutted. Pretty well all of them strutted in. A couple of years ago, even the hon. Member for Northampton, South was an enthusiastic supporter throughout the country. He gave almost as much support to the proposals then as his right hon. Friend is giving to the present proposals. We see no great difference between them. Anyone who studies the reality will see that they are very much the same proposals—the same proposals which the right hon. Lady forced on her subservient Cabinet and the same proposals which they devised in the Cabinet committee that had never examined any of the proposals and objectives from the medical profession or the British Medical Association, as the hon. Gentleman will be keen to confirm. Even more serious is the fact that the heads of the royal colleges pleaded with the Government, the right hon. Lady and her subservient Ministers to listen. We could have been saved all that trouble.
Five months, 10 months or two years ago, huge sums of money could have been saved. I am not sure whether we would have saved more than the losses on the poll tax— that would certainly mean setting it pretty high. As my hon. Friends have often said, we could have had a united, intelligent review of the health service.
Aneurin Bevan was never opposed to reviews of the health service. He even said that they should happen every five or 10 years to see how we should make the best advances and how we could make the whole apparatus more democratic. Indeed, he set out the measures to do that. In 1958, in his last speech on the health service, he told the Conservative Government, "You have had about five or six Ministers of Health. They have not been much good because, apart from their other disqualifications, they have been here such a short time that they are unable even to learn their job, and the main point of their job is how to stand up to the importunities of the Treasury." That was the delicate way in which he described it.
When we win the next election, as I am sure we shall, I hope that my hon. Friend the Member for Livingston (Mr. Cook) will be given the same five-year period at the Ministry of Health as was given to Aneurin Bevan in 1945. When he was given the chance, Bevan said, "I want to stay here for five years to carry through the whole programme." One of our very best days since 1948, when the NHS provisions were introduced, will be when my hon. Friend the Member for Livingston, who has earned so much respect because of the way in which he has put his case, takes up the office of Secretary of State for Health and starts to clear up the terrible mess that the Conservative Government have made.

Sir Timothy Raison: I am one of those who enjoys listening to the right hon. Member for Blaenau Gwent (Mr. Foot) speaking as Aneurin Bevan's vicar on earth. It will be a sad day when we can no longer hear him speak in the House. Unusually for him, when the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) spoke on behalf of the Liberal Democrats, he used a tired phrase; he talked about health being treated as "a political football". I think that we all know in our hearts that that will continue and that there is absolutely no possibility of the House of Commons ceasing to take an interest in health or of its ceasing to do so in a thoroughly partisan way. Indeed, it is right that we should debate the health service in the Chamber and even inject party politics into the subject.
Having said that, however, we are reaching a situation when the Labour party's posture on this matter—and especially that of its Front-Bench spokesmen—is becoming more and more ludicrous. The scale and nature of Opposition Members' attacks on the health service are totally misleading and mendacious. Their case is becoming absurd and beginning to fall apart.
We all heard the hon. Member for Livingston (Mr. Cook) once again trailing out a list of touching hard cases. The public are beginning to see through all that. It is time that the hon. Gentleman looked for something else to talk about. I notice that he is about to leave the Chamber, and

I do not blame him for that. He talks a lot about long waiting lists, but the longest waiting list is the one that he is on in his search for office.
I genuinely believe that my right hon. Friend the Secretary of State has managed to reverse the gravamen of the political onslaught in the past few weeks. The way in which he has responded to Labour's irresponsible attacks and has clearly shown exactly what is happening in the health service has been enormously to his personal credit. It is beginning to get through to the public that there is something false in the Opposition's assertions.
I firmly believe that our structural changes are on the right lines. The introduction of the trusts and of budget-holding practices is a thoroughly good idea. I do not go along with those who say, "Let's sit back for a few years to consider whether they are a good idea." It would be totally wrong to block the growing impetus for reform in many parts of the country. I do not know what people in Scotland and Wales are saying—perhaps they do not want to experiment with trusts—but the blocking or deferral of the proposed trusts in my part of the country would lead to great disappointment. Anybody who has looked at what is happening or talked to the people involved will know that what I am saying is true.
I do not claim that we have always got our health service reforms right. It is pretty obvious that our reforms at the beginning of the 1970s were wrong. Although I dutifully voted for them, I now think that we introduced a grossly over-bureaucratic system in which tier was piled upon tier. That had to be dismantled. I am not trying to claim any unique virtue for my party's approach to such things, but I believe that we have now evolved a system that offers the possibility of a greater directness of management. It will be a much leaner system than in the past and one in which decisions will be taken where they should be taken. To use a naval analogy, we are trying to ensure that decisions will be taken on the bridge of the ship rather than in the Ministry of Defence. If that principle is sound in war, which it most certainly is, exactly the same should be true of running the health service.
As a result of the reforms, I believe that we shall see a more clear-cut management with incentives to efficiency through competition. It was interesting that the hon. Member for Livingston ended by saying that a Labour Government would be looking for incentives to try to increase efficiency and to reward success. Curiously, therefore, at the end of his speech he started to concede part of the philosophical argument. Of course, a Labour Government would not actually do that, whereas we have found a system that will achieve it. Indeed, until recently, socialism everywhere always led to a bureaucratic approach. The irony is that socialists elsewhere are now beginning to recognise the failures of the bureaucratic approach and are working hard at decentralisation. That is happening in the countries of eastern and central Europe —only the British Labour party is living in the past.
We all know that the health service will not be magically transformed overnight. Nobody expects that. However, given time to mature, I believe that the new system is heading in exactly the right direction. I should like to illustrate that point by examples from my constituency where the state of play is that we have four trusts or potential trusts. One has just been approved by the Secretary of State; one has been deferred; and two are included in the third wave.
The new trust that was accepted last week is the Aylesbury Vale community healthcare trust. I am sure that it will be outstandingly successful. The trust will cover adult mental health, the elderly mentally ill, mental handicap, physical rehabilitation and general community work, such as district nursing, health visiting, chiropody, and palliative care. It will come into being with strong popular support. Indeed, there was very little opposition to it at the discussion stage. Those who will operate the service are committed to it and the community health council supports it. It would be a bitter blow to say to those people, "Sit back, go away and do nothing for the next year or two." As I said, I can see no reason why that trust should not be outstandingly successful.
The trust in south Buckinghamshire, to be based around Wycombe, was deferred. Although that is sad because much good work went into its preparation, I do not necessarily blame my right hon. Friend the Secretary of State for deciding to defer it, because it would be a single-district trust and I have always had some reservations about whether such trusts are the right way of proceeding. Perhaps some financial questions remain to be resolved. I am delighted, however, that although my right hon. Friend has made it clear that he cannot accept the application at this stage, he believes that the trust will be able to go ahead in due course and he will consider its application sympathetically. If we were to have a single health authority for the whole of Buckinghamshire instead of three different health authorities, I am sure that we would overcome the single district trust problem and that such a trust would then have the viability that it does not have at the moment.
The proposed third wave for the county ambulance service seems to make good sense. The other proposed third wave trust would cover Stoke Mandeville hospital. Although it is famous for its spinal injuries unit, it is, of course, a district general hospital as well. It has had some difficult problems and some disappointments over the delay in its redevelopment programme. It has also had various other problems, including overspending. Again, I believe that the best way of tackling those problems and of making use of its highly skilled staff would be to run the hospital from within the unit rather than imposing management from outside.
I am not criticising the past management, although they have had their difficulties, but if one asks what is the best way of running a unit that faces problems, of having a happy staff, of building up their morale and of tackling some tricky development problems, who could seriously deny that that is far more likely to be achieved by managing the unit from within—rather like a battleship —than by imposing the management from outside?
I believe that the underlying philosophy behind what we are setting out to achieve is absolutely right. Of course, there will be problems. The health service will be underfunded, but then, it will always be underfunded. Anyone who is honest will accept that it will always demand more and more money. However, on the crucial question of how we can best tackle the problems, increase morale and achieve clear-cut decision making, I believe that the idea of the trusts is right. It would be a great error to be pushed off course and to delay or abandon their implementation.

Mr. David Young: The Conservatives have always argued that the national health service is safe in their hands. In fact, it is about as safe as a chicken in the hands of a farmer who is about to wring its neck. The public support for the Labour party stems not from propaganda but from ordinary people's experience of the health service—people who are told that they have to wait for one or two years on the waiting list for an operation but that if they paid privately they could have the operation within days or weeks. That is not choice—that is extortion.
The Government have consistently argued that we have a free health service, but by extending the payment per prescription from 20p to £3·40, they seem to have flown in the face of that principle. They have certainly cancelled eye tests. They have also cancelled the dental test. The main sufferers when such tests are cancelled are the young and the old—the people most at risk whom we as a community should seek to help. If high blood pressure and glaucoma are not detected in an eye test, does that not lead once again to hospital lists being extended by people who have to go for remedial treatment, when preventive treatment would have been less costly?
During the past 12 years, we have seen the Conservatives create a two-tier health system. With 900,000 people on the waiting list, the incentive to the patient to go private is not choice but pain. The Government's policy has made the long waiting list the recruiting sergeant for private practice. A two-year waiting list may be acceptable to the Secretary of State, but when an 81-year-old woman is waiting for a hip replacement, the question which goes through her mind is, "Will the surgeon get to me before the undertaker does?" That is the choice that the party of choice provides.
Underlying the whole system is the fact that the quality of life of people on waiting lists is affected and undermined. In a civilised society, we should consider quality of life, if nothing else. The Conservative party claims to be the party of choice. What chance is there of going to the hospital of one's choice if one wants to go to a hospital to which the district health authority has not contracted out and if the extra referrals budget has gone by the board? What choice is there then?
What choice is there for the single elderly person who requires long-term nursing care if there is little or no community budget? What choice is there except a private nursing home? I am aware of what the Secretary of State for Social Security has said today about giving more money to such people, but unfortunately it is not elderly people but owners of private nursing homes who will receive the extra money. We shall soon see the charges at those private nursing homes increase once again.
However, that is not the question. What about the many people just above the benefit level and those who throughout their lives had saved for a rainy day? It will be a pouring day when they have to fork out £15,000 to £20,000 per annum for private treatment in a nursing home. What about people who are told that they have to sell their home in order to obtain treatment? Where are they when they can no longer afford that treatment? Will they be downgraded, as in America, from one nursing home to another? Is that the type of society that the Tory Government want? It is certainly the kind that they have created.
As a Member of Parliament for Bolton, I have always been concerned about the health of Bolton. No hon. Member who represents that area can be otherwise when one reads the Black report and other reports from the director of medical services which tell one about the health of Bolton. On 27 January 1981, I got the go-ahead from Sir George Young for the new Bolton general hospital. For almost a decade the Government failed to come across with the money. If the speculation in yesterday's Sunday Mirror is correct and the £37 million is to be diverted for other purposes—the article mentioned opting out and hospital trusts—that will be a gross betrayal of the people of Bolton.

Mr. Thurnham: The hon. Gentleman says that he is concerned about health in Bolton. Will he retract the bogus scare stories to which he was party about cancelled operations in the north-west? Does he accept that no health authority has said that there is any truth in it? In Bolton, there were only 651 operations not cancelled, but postponed, and 780 operations were put off because patients did not turn up for them. Is that financial cuts?

Mr. Young: I wish that the hon. Gentleman would use his own time and not mine. He will have a chance to make his speech. I have represented Bolton and I know of the cuts. One of the things that sickens the people of Bolton is this. When the right hon. Member for Finchley (Mrs. Thatcher) says, "I want the surgeon of my choice at the time of my choice," that is fair. But it is not fair that her policies have denied that to everyone else. A plasterer in my constituency has to remain idle because he has months to wait before he can have an operation on his elbow. That is what I am talking about when I complain about waiting lists.
It is no wonder that certain hon. Members become coy when they attack us on our assertions but will not declare whether they and their families depend on the national health service. That is the only criterion on which to judge whether people believe in the national health service. If they do not go into those hospitals or see the waiting lists, it is easy to argue in statistical terms, but one person on the waiting list for two years is one too many. If there had been an incentive to remove the waiting lists, it could have been done. Instead, the Government provided handouts in terms of private health insurance for the elderly, which the Secretary of State has retracted now that an election is approaching. I want a health service for all the people, not just for those who can buy their way out of the system. That is the health service that we want in Bolton and for the country—and that is why, after the next election, there will be three Labour Members of Parliament for Bolton.

Sir Jim Spicer: I am delighted to follow the hon. Member for Bolton, South-East (Mr. Young). and most hon. Members owe a great deal to the national health service over many years. I certainly do in personal terms, but even more in family terms.
My eldest daughter broke a leg. She had a broken leg for eight years. During that period she had 14 major operations. The last one took thirteen and a half hours. She is now walking on that leg and is healthy. Not once did she dream of moving out of the health service, and not

once did she not receive superb treatment. I am sick and tired of hon. Members who try to say that we have the worst service in the world. We have the best service in the world, and the sooner we all recognise that, the better.
I am sorry that the hon. Member for Livingston (Mr. Cook) is not here. I, too, shall return to that marvellous television programme, "On the Record", which I enjoyed enormously yesterday. In that programme, the hon. Gentleman was trying to be a good fairy—I mean that in the nice, old-fashioned sense. He was saying, in effect, "Vote for me and all will be well." As my right hon. Friend the Secretary of State made clear, the hon. Gentleman avoided some questions. First—this question will return time and again—how much additional funding does the Labour party believe to be essential for the NHS? Is it £2 billion a year, £3 billion, £4 billion, £5 billion or £6 billion? Hon. Members can ask that at various times of various Labour-Front Bench spokesmen and they will always get different answers.
My second question relates to the hon. Gentleman's speech today. How will he translate his obvious dislike of and distaste for private residential care, where so many elderly people reside with the help of the Government, into action if, unfortunately, he ever becomes the Secretary of State? Hundreds of thousands of people throughout the country would like an answer to that question.
I knew a geriatric hospital with wards of 10 or 20 beds which was to be closed. The spirit there was marvellous. I followed the case of each patient moved from that hospital. One old lady said to me, "I never thought that I would be able to live out my life in a room of my own with a view like this—I thought that I was condemned to living in a ward for the rest of my life." Is the hon. Gentleman against taking elderly people out of hospital institutions and putting them into private accommodation? The country and certainly my constituents would like to know.
The same "good fairy" gave the impression that he would wave a wand and, miraculously, the money to achieve everything would appear. He said that it would come from "the economy", but what possible growth in the economy can we rely on under a Labour Government? How many years does he expect that it will take to wipe out his theoretical underfunding? Yesterday the hon. Gentleman was coy about that, as he has been in the past. As my right hon. Friend said, the hon. Gentleman has changed his tack and stance on this time and again.
My third question is: how carefully has the hon. Gentleman researched authorities with trust status? In particular, has he looked at the West Dorset health authority, which has been fully trusted for its acute, community and mental health services since April? Perhaps he would like to visit us. If he or the hon. Member for Peckham (Ms. Harman) would like to come, we should be delighted to welcome them. They would see the resounding success achieved through wonderful co-operation between the authority, the trusts, the consultants, the doctors and all health service employees.
I will give some quick examples of what we achieved. From an annual budget this year of £77 million, we have already achieved a saving of £1·3 million, which will be devoted entirely to cutting waiting lists. Since April, 80 per cent. of patients have been treated within six months. Soon none will wait more than a year. Nobody will wait for two years, as the hon. Member for Bolton, South-East said. Even that one year wait will be exceptional. For each of the past three years, 6 per cent. more patients have been


treated. There is a total commitment to the second phase of our splendid district hospital, which will combine all our acute resources on one site. Coupled with that, we have major improvements in all our community hospitals under our community trusts. On the mental health side, we have seen the closure of Harrison and Coldharbour hospitals —two marvellously run hospitals, but built 150 years ago. Their patients are now back in the community. I have seen what has been achieved even in six short months, and it is remarkable.
Will someone from the Opposition Front Bench please come and look at what is happening in west Dorset? I extend the same invitation to the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy). He mentioned Yeovil hospital. That was where my daughter had most of her operations. There is no better hospital. It has trust status. The hon. Gentleman said that the right hon. Member for Yeovil (Mr. Ashdown) visited the hospital recently and discovered that some people there were unhappy or, at least, uneasy about the future. Perhaps he talked to different people, because I have spoken to some people there in the past three or four days and they are happy.
I hear that the number of patients treated in Yeovil hospital is up by 5 per cent. since April, that waiting lists are substantially down and that only 63 patients have waited for more than a year, a decrease of 70 per cent. on last year's total. The hon. Gentleman said that he was sure that there must be a fly in the ointment somewhere and that the hospital would probably run into financial difficulties. It will not. It has a balanced budget. It is appointing five new consultants, three arising directly from the trust status, and more improvements are expected across the board. I am delighted that the right hon. Member for Yeovil will gain so much in his constituency as a result of the policies instituted by the Government and I hope, although I fear that it is a forlorn hope, that he and his colleagues will vote with the Government tonight.
I have made my position clear. I depend on the NHS and always will, and so will my family. So long as we have a Conservative Government wholly committed to it under our present Prime Minister, that NHS will continue to operate at an increasing level of efficiency and with better management. As has been said, proper management of scarce resources is the key. We cannot go on always throwing more money at the NHS. We must use that money more efficiently. Surely no one can deny us the right to do that.

Mr. David Hinchliffe: The simple fact which neither the hon. Member for Dorset, West (Sir J. Spicer) nor any Tory Member who spoke before him has addressed is that the majority of British people believe that the Government are intent on privatising the national health service. The public are witnessing the obvious break-up of the NHS by a Government who have no electoral mandate for such action. It is the logical action of a Government who have privatised numerous state industries and who have a pathological hatred of collectivism, co-operation and of the socialism inherent in the principles of the NHS. It is the logical action of a political party that voted against the introduction of the NHS way back in the 1940s before I was born. The public are not stupid. They can see the obvious steps that have been taken in the direction of a health care market.
My right hon. Friend the Member for Blaenau Gwent (Mr. Foot) said that the Government had used certain processes in pursuing their policy and he identified one such process as destabilisation. Certainly the Government have destabilised the NHS as they deliberately decided to underfund it. According to the National Association of Health Authorities, the NHS was underfunded to the tune of £2·5 billion in the first 10 years of the Government's term of office. At the same time, however, the Government were able and prepared to give income tax concessions to people who already had plenty of money. We now see the results of that underfunding, because a quarter of all the NHS beds in Yorkshire have been closed. Not all those beds were for psychiatric or mentally handicapped patients; 15 per cent. of acute beds have been taken out of use within the Yorkshire regional health authority.
Industrial disputes in the NHS have been provoked deliberately. Those disputes included the nurses' legitimate claim for a decent working wage and the decent claim from the ambulance workers for an appropriate working wage in recognition of their expertise. The pay awards that were eventually arrived at were not funded by the Government.
The public see before their eyes that paying for health care is becoming the norm. They have witnessed the huge increase in prescription charges and the introduction of charges for eyesight and dental checks. The Government also introduced income tax concessions for private health care, the ultimate insult to a generation of elderly people who, in common with my right hon. Friend the Member for Blaenau Gwent, were around at the time the NHS was set up. Those people fought for the NHS, so is it any wonder that the Secretary of State has had to concede that that tax concession has been a shambles? Those elderly people do not believe in the concession. They share our commitment to a properly funded NHS, available to patients at the point of need.
The care of the elderly has been privatised. There are now 5,000 fewer elderly care beds in the hospital sector. In my area of Yorkshire, the number of private nursing beds has increased by 1,000 per cent. Hospital trusts, such as that in Bradford, have stated that they do not accept any responsibility for the nursing care of the elderly. They do not regard that as their job. In my constituency, NHS hospitals which were supposedly unsuitable for the care of the elderly have been closed. Sandal Grange is a classic example; it has reopened as a private nursing home. That is happening across the country.
The county hospital which previously cared for the elderly in my constituency has also been closed. We had been promised a new geriatric unit at Pinderfields hospital, but that has not come about. The old hospital has not been replaced. Snapethorpe hospital, recently rebuilt, has also been closed for the care of the elderly. Patients must now pay to go to private nursing homes to receive the care that they previously received from the NHS. Is that not equivalent to the privatisation of the NHS? Of course it is. My constituents know what is happening.
Charges have been introduced for the use of NHS facilities. Surely if people are charged to park their vehicles in hospital car parks, that is equivalent to privatisation. That is what has happened in my constituency. The people are being penalised. It is all right for Conservative Members to sneer at that, as car park charges may mean nothing to them—it is pocket money. However, for elderly people who struggle to run a car, such charges mean a great deal. Those people need their cars to get to hospital


to visit their loved ones or to receive treatment. Conservative Members may sneer about that, but such charges are all part of the privatisation of the NHS.
Private consultation for my constituents is becoming the rule rather than the exception. It is the norm for people to have to pay to see a consultant before they are accepted into the system. Frequently they end up paying to visit Methley park hospital for private treatment. They should receive that care within the NHS by right.
It saddens me to know of case after case of elderly people who have paid all their lives towards the NHS and who believe in it. They now have to bribe a doctor to get the treatment that they should get by right. That is an absolute disgrace, but it is the reality in my area and elsewhere.
The public have also witnessed the reconstruction of the NHS—prompted by Government measures—as a com-petitive set of business units. Whether people have trusts in their area or not, the pattern is clear. The introduction of private-sector style management—a great success, according to one Conservative Member—has not been a success in my area. A man who used to run a biscuit factory was brought in to run the local NHS, but the mistakes made during that period are still being put right by the new management.
Conservative Members talk about the devolution of accountability—what absolute rot. What is the role of the community health councils? Supposedly they represent the voice of the patient, but that voice has been made to shut up. In my area, the CHC is no longer able to discuss anything in the meetings of the area health authority. It is unable to have any dialogue on issues of direct concern to it.
Obvious financial incentives have been offered to general practitioners to opt out of the system. I recently received a letter from a local GP in my area who described the way in which financial incentives are offered to GP practices to opt out and to become self-managing. He described the way in which Yorkshire regional health authority operates. He wrote:
In order to improve waiting list statistics they are seeking GP's help in removing from the waiting-lists those patients who have been waiting longer than one year. I presume they are hoping patients can be referred to a different Provider and so in terms of statistics would start their waiting period again. They are also hoping we will remove patients who have changed addresses, died, no longer need treatment or can be persuaded to opt for private treatment. Fund Holding practices will be paid a 'bounty' for each patient removed from the waiting list and a 'bonus' if on 1st April. 1992 there are no such patients. Yorkshire's Non-fund holding practices are to be asked to carry out the same 'ghost-culling' exercise but will not be paid for doing so. Whilst not giving any direct benefit to patients of Fund Holding practices it allows those practices to gain financially and therefore purchase better equipment and services for their patients. In essence it is a further financial carrot to encourage practices to become fund-holding and to strengthen the position of existing fund holders at the expense of non fund-holders.
That is a clear example of the way in which the Government are pushing public money at GPs to persuade them to manage their own budgets.
The Labour party has been accused recently of running a dirty tricks campaign about the NHS. I took particular note of a disgraceful article that appeared in The Sunday Times a week ago on the issue of Dr. Mark Baker moving to a consultant's post within the Yorkshire regional health

authority. The news editor of The Sunday Times, Mr. Michael Williams, has accepted that that article contained at least six factual errors. He undertook to print, in full, a letter from me refuting the allegations in the article. I am sorry that Mr. Williams is not a man of his word, as he removed the main point of my letter—that Dr. Mark Baker had confirmed on BBC television the precise information I had released.
There is no need for dirty tricks, as it is quite apparent—

Madam Deputy Speaker (Miss Betty Boothroyd): Order. The hon. Gentleman has had his time.

Mr. James Couchman: In common with my hon. Friend the Member for Northampton, South (Mr. Morris) may I first declare that I have an interest in two health care companies? I advise Pfizer, which is a Kent-based pharmaceutical manufacturer, and Denplan Ltd.
In common with my hon. Friend the Member for Dorset, West (Sir J. Spicer), may I also declare a family interest? Like the vast majority of the population, my family and I use the NHS for all our health care. Some colleagues will be aware that, during the past 18 months, my wife has been a cancer patient at Guy's hospital. During that time, she has received superb treatment and enjoyed the morale of the staff, which is extremely good. Throughout her serious illness, she has always been treated in a most encouraging manner. My family has always enjoyed satisfaction from the health service, and we use it exclusively for our health care.
I find it deeply insulting when Labour Members accuse us of wishing to privatise the health service. Why would we, who have enjoyed satisfaction from the national health service, wish to deprive others of such satisfaction? Opposition Members' actions in the past few months seem to have much more to do with propanganda and scare than with telling the truth about the health service as it is or would be under a Labour Government. It is regrettable that the nostrum of those propagandists of the 1930s and 1940s—that if a fabrication is repeated often enough it will be believed—has been taken up by Opposition Front-Bench Members.
I remember sitting throughout the entirety of the Bill for the reform of the health service that we are now discussing—the National Health Service and Community Care Bill. During those proceedings, there was little mention of privatisation. That was not the Opposition's objection at that time, and I suspect that their attempt to persuade people that we intend to privatise the health service has much more to do with elections than with telling the truth.
I, too, watched that excellent programme on BBC1 yesterday lunch time in which the hon. Member for Livingstone (Mr. Cook) was interviewed by Jonathan Dimbleby. What a slippery and evasive performance the hon. Gentleman gave, especially in relation to the resources that a Labour Government would provide for the health service. He did not say whether it will be £1 billion, £2 billion, £4 billion or £6 billion, but it does not matter, because the right hon. and learned Member for Monklands, East (Mr. Smith) will not pass over that money in any case.
The right hon. and learned Gentleman will take additional income tax and national insurance from all doctors and most nurses, and not a penny piece of ii will be paid to the national health service, because all that additional revenue has been pledged in social security benefits to pensioners and in child benefit. I wonder how nurses and doctors will feel about that. They will say, "It's back to the same old swings. We remember the last Labour Government when our wages were reduced—nurses' by 3 per cent. and doctors' by 17 per cent."
That is in stark contrast to what the Government have done for the pay of nurses and doctors. In real terms, nurses' pay has gone up by 48 per cent. and doctors' pay by 39 per cent. Since 1979, spending on the health service has increased by 50 per cent. in real terms. The hon. Member for Ross, Cromarty and Skye (Mr. Kennedy), who is in his place, mentioned the increases that will be necessary. The Government have kept pace with those, but demand in the health service is infinite. It does not matter how much more money a putative Labour Government might put into the health service, because it would never be enough. It would always be outstripped by medical advance and the number of elderly people who require tremendous extra service.
Some 84 per cent. more patients are now treated in geriatric units. That is partly to do with the fact that it is no longer seen as the end of the road to end up in a geriatric unit bed, because geriatricians now work extremely hard to rehabilitate the elderly when they come into their charge. They may then go to a home outside, where almost all of them are supported by the state in some form. Some 293,000 people are now in homes supported by public funds, compared with 132,000 in 1979. Thus, more than twice as many people are now in homes for the elderly supported by public funds. That is the sort of improvement that has taken place since 1979.
We are constrained to speak for only a brief time this evening, but I should like to have said much more in this debate. I welcome the inquiry that my right hon. Friend the Secretary of State has set up into the situation in London. I was chairman of a health authority before entering the House, and I have long been convinced that
London, especially inner London, is over-provided with health care. There is too great a concentration of high specialist units in the undergraduate teaching hospitals on the three-mile ride from Harley street which we all know and which has been recognised since 1909.
I hope that Sir Bernard Tomlinson, in his wide-ranging inquiry, will consult on the problems caused by over-concentration in London. There is no doubt that the hospitals on the inner London ring are starving constituencies such as mine—30 or 50 miles outside London—of resources. St. Thomas's hospital has had to give associate university status to the hospital in my constituency because insufficient ordinary or secondary care patients are going into St. Thomas's and there must always be 40 medical students at the Medway hospital because more people are living there.
I hope that Sir Bernard will be given a free hand to recommend the movement of those undergraduate teaching facilities out of London and into the provinces where they should be. That would remove at a stroke the reason for keeping too many of those hospitals open. I look forward to Sir Bernard's report being published soon.

Mr. Robert Hughes: I shall concentrate on the application for trust status by the Forresterhills hospitals in Aberdeen. The foreword of the application document says:
The Hospitals represented in this application have an excellent record of service to the public over many years. They are a most valuable asset for the people of the area and they play an essential role in the lives of each and every one of us.
I concur wholly with that and it is interesting that, in the rest of the document, not a single case is made about the applicants, who are involved in the health service in Aberdeen, being frustrated in their management or in making improvements. Nor is there any evidence to say that they could improve on what has gone before, except a vague promise of more flexibility.
On 9 October, which is less than a couple of weeks ago, the 90-day consultation period ended. Within five days of its ending, Grampian health board was able to write to the Secretary of State to say that it upheld and recommended the application. Some will say that it has acted with commendable speed. The Secretary of State for Scotland would certainly not take that view, however, because a local event of national importance is to take place in the locality covered by the hospital—the Kincardine and Deeside by-election.
The electors in that constituency will want to know when the Secretary of State will reply to the application and what response he will give. They will ask the Secretary of State and every Minister who goes there whether they agree with the Tory party candidate in the by-election who is opposed to opt-out status. Everyone is opposed to it, and the application should be refused. If Grampian health board was not prejudiced by its judgment before the application, when it said that the application should go ahead, it, too, would recommend rejection.
As for the consultation process, there were 3,919 responses of which 13 or 0·33 per cent. were for the application; 40 or 1·02 per cent. expressed no opinion, but said that they were certainly concerned; and 3,866–98·65 per cent.—were against the application. In addition, the People's Hospital Campaign in Aberdeen, which I co-chair with my hon. Friend the Member for Aberdeen, South (Mr. Doran), entered a petition bearing 34,627 signatures.
One would think that Grampian health board would take account of the weight of all that evidence. In its letter to the Secretary of State the board says that it is worried about the number of objections, but goes on to discount them. It takes an interesting line, saying that the problem is that 3,559 of the responses were standard letters prepared by the People's Hospital Campaign and cannot be taken into account. The lives of Members of Parliament would be much easier, but we would be a damn sight less popular, if we replied to every standard letter that we received by saying that we did not take them into account. The Secretary of State would be surprised if that were so.
It is an insult to public opinion to reject such responses out of hand. However, let me be more than fair. If the vast number of responses received in the form of the People's Hospital Campaign standard letter are taken out of the total, we are left with 360 responses, of which only 13 were in favour, so the 0·33 per cent. in favour becomes 3·61 per cent.—hardly a mandate to proceed. The balance of judgment is entirely wrong.
Grampian health board's second line of attack is to say that the people do not understand what they are talking


about, because they do not understand the process. The unit area medical advisory committee opposed the application. The area medical committee, covering the whole of the Grampian region, objected. The hospital's senior medical staff committee and the local medical committee, which represents general practitioners in the Grampian region, opposed the application. Every organisation and group involved with the health service opposed the application. For the health board to say that people do not understand what is going on is to denigrate all involved with the health service.
We were told that the consultation process was wide. The applicants produced a pamphlet in a tasteful shade of blue that spelt out the trust's advantages. At best, the pamphlet is disingenuous, and it also shows some incompetence. I received my copy only a fortnight before the consultation period ended, and I have no particular reason to believe that I was singled out. At the end, the pamphlet states:
Any other comments or expressions of support which you would wish to have taken into account should be sent direct to…
It does not state that one can object. That is the so-called open consultation that the Government say they support —the pamphlet is, to put it mildly, disingenuous.
We are told that the proposal involves local choice by local people. The chairman-designate of the trust was approached by the chief executive of the NHS in Edinburgh—such is the local choice that those involved could not even choose their own chairman. What choice will they have once the application goes through? What about the others involved? Who asked them? Is the decision locally inspired, or is it imposed from above? I suspect that it is imposed from above.
The Government say that we are telling a lot of lies about privatisation, but let us consider what is happening in Aberdeen. The health board built, planned and paid for a 60-bed unit for its geriatric and psychogeriatric patients. It was planned that, from the day it opened, it should be run by the health service. But it has been contracted out to be run by a private medical company.
Within the Aberdeen health board district there is a hyperbaric centre which was developed in the 1980s to take care of divers in the North sea who need urgent medical treatment for the bends. That centre was included in the application, but it has already been stripped out. It was sold to a private company on Friday. The medical professionals running that centre have been told to clear their desks and get out within the week because their offices have been sold to a private diving company. The centre does not deal with marginal problems but saves lives; it is of great importance. It was sold off because it would cost money and was an expensive part of the service to develop, which is exactly what we said would happen. Services which are not commercially popular and which will be a drain on funds will be sold off. Another centre which deals with disturbed children who need psychiatric care was stripped from the application because it created difficulties.
Some two thirds of the land is owned by the health board and one third by the university. As the hon. Member for Ross, Cromarty and Skye (Mr. Kennedy) asked, will the land be free? Who will pay for it? Do we expect the trust to pay for it? It would never be able to borrow the

money to pay for the university land, and the university cannot afford to give it away for nothing. Borrowing the funds would affect patient care. It is an absolute disgrace. Privatisation is proceeding apace and everyone in the House, including Conservative Members, knows it.
Everyone of repute in the Grampian region has opposed the application. Every candidate in the Kincardine and Deeside by-election opposes it. No case has been made approving the application. That is recognised by everyone, including the Tory candidate and every Conservative group on the regional and district councils. Every Conservative is against it. Are all those views to be overridden? It does not matter whether they are or not, because the electorate will override the Secretary of State come the Kincardine and Deeside by-election and, what is more, the electorate will override the Government come the general election. We shall have a service which is true to its principles, is free to people at the time of need and provides the best care. I support that, and I believe that the whole country supports it.

Mr. Richard Page: It is fascinating how a phrase or word sometimes encapsulates in the public's mind a concept or idea. It is then either given the fair wind of approval, or rendered stillborn or handicapped at birth. I well remember, when I was in opposition, standing in the Chamber in early 1979 and using the phrase, "a winter of discontent". I do not claim copyright on that phrase, because I understand that an itinerant playwright had used it a few centuries before. But the phrase encapsulated in people's minds the Labour Government's embattled argument with their paymasters. The words used by the hon. Member for Livingston (Mr. Cook) jarred with the truth as he started to say how well the Labour party had treated the national health service during its time in office.
I do not know who developed the phrase "opt out", but in doing so he or she created a fertile base on which the Labour party has been able to develop the various fears that it has put into the public's mind. When Lord Callaghan was Prime Minister, he once said that a lie could be halfway round the world before the truth had got its boots on. I have always borne that in mind, and we must get our boots on if we are to get round the world and nail the lie being circulated about the Government's attitude towards and plans for the national health service. That was one of the reasons why, last Wednesday—

Mr. Robert Litherland: Will the hon. Gentleman give way?

Mr. Page: No, I will not, as I am restricted to 10 minutes.
Last Wednesday, I tabled an early-day motion and immediately received 100 signatures for it. The motion deplored the scares and smears put about by the Opposition, and gave a commitment by Conservative Back Benchers that the health service would not be privatised, but would stay as a national service. I say bluntly that I would find it difficult to be a member of a party that did not provide health care for every man, woman and child in this country, irrespective of their private means.
Constituents have asked me why we are introducing change and proposing trusts which, they say, the doctors


and consultants do not want. I have been forced to spend time explaining that the medical profession has not been of the brightest when taking managerial decisions. The medical profession was not in favour of the national health service in the first place.
I remember the furore over the funds for generic drugs. I remember doctors threatening to put up a reply to that idea in their surgeries—at least, that was what was said by doctors who were not on holiday in the West Indies enjoying the hospitality of some of the drug companies. The doctors have complained about budgets and trusts, but some of them are beginning to say that perhaps trusts are not so bad after all. Even their budgets, they say, are fine. They have started to realise what lies behind such schemes.
This series of poor initial judgments by some members of the medical profession has been seized on by the Labour party and used for its own ends. If my constituents persist, I shall also tell them another reason in favour of the changes. For four years, I have been privileged to serve on the Public Accounts Committee, and whenever a national health item comes to my attention, I have two conflicting emotions. The first is that this is a juicy item that we can get our teeth into—such items are always juicy: taxpayers' money is always being wasted. The second feeling is that I should put my head in my hands in despair at this waste of taxpayers' money under the present system. If Opposition Members want to sneer at these changes, I suggest that they work their way through some National Audit Office reports. They can then come back and tell us whether they think some changes should be introduced to the health service.
A recent example concerned health service supplies in England. I was struck by the absence of management data about them. If the NHS had gone out of its way to make life difficult, it could not have done a better job. It was
impossible to compare regional data, because there was no common management system throughout the 14 regions.
I offer a few simple quotes from the NAO report:
The absence of readily available information about purchases from individual major suppliers weakens the negotiating position.
That is not the best way to look after taxpayers' money. From a commercial point of view, it is the most damning part of the exercise:
The NHS lacks the detailed data needed to carry out more penetrating but selective reviews of key business factors".
The plain fact is that the system does not have the information on which to make the necessary judgments.
The NAO found that such basic information as a list of the top 50 items by value purchased in the past two years was not available. Even the top 30 suppliers to each region could not be named.
I could go on, but I will not. I will not discuss the report on patient transport services or that on operating theatres, although I am glad to say that, following the NAO's report and the PAC's report, the usage percentage has risen from 50 or 60 per cent. to between 75 and 90 per cent.
There is no time to discuss the detail of the trusts or how they can be more efficient and can save taxpayers' money, allowing that money to be ploughed back into better services. Central control has not worked. The way forward lies in local control through local choice and local management. People should be paid for what they do. My hon. Friend the Member for Gillingham (Mr. Couchman)

talked about money going into London and not into the shires. In the shires, we are doing excellent work and performing a great many operations at even lower cost.
Of course there will be errors and failures among the trusts, but they will be as nothing compared with the overall benefits and advantages.
The unfounded allegations about privatisation are being nailed. When the public realise that they have been duped by the Labour party, the backlash will be terrible, and it will be visited upon Opposition Members when the election comes.

Mr. Jim Cousins: It simply will not do for the hon. Member for Hertfordshire, South-West (Mr. Page) to complain about a lack of information in the NHS, given that it was by proceeding so boldly without adequate information that the Government got into the mess that they are in. It was not sensible of the hon. Member for Gillingham (Mr. Couchman) to complain about the Government's belated discovery of the financing problems of the London teaching hospitals. All those things should have been known in advance and represent unnecessary difficulties into which the Government plunged through lack of foresight.
Labour Members are sensible enough not to imagine that the problems of funding teaching hospitals are confined to London. Some of the difficulties experienced by NHS opt-out trusts throughout the country are due to the difficulties in the system that the Government designed to try to fund the activities of medical and dental teaching —precisely the problems that they have now discovered in London.
The Opposition did not invent the ridulous machinery that is now crumbling around the Government. The Government complain about the costs of bureaucracy in the NHS, yet in an effort to control those costs they have utterly failed and, incredibly, costs have soared. In Newcastle upon Tyne, two of the four main hospitals now form NHS opt-out trusts—yet the costs of administering the district health authority have risen by 100 per cent. in two years due to lack of foresight on the part of the Government, who have only themselves to blame. The new, slimmed down Northern regional health authority costs 25 per cent. more to administer now than it did two years ago. These are the Government's failings and no one else's.
It was not the Opposition who decided that it was a fine idea to let private wings sprout in hospitals all over the country. That is what has happened at the Royal Victoria infirmary hospital in Newcastle, and that is proposed for the South Cleveland hospital. It was not the Opposition who designed the consultation procedure for NHS opt-out trusts. Incidentally, the two trusts recently approved for north Tees and south Tees, near the Langbaurgh constituency, failed to attract the support of one Conservative Member of Parliament from their area when applying for trust status.
It was not the Opposition who looked at the old long-stay geriatric hospitals, which were certainly a problem, and came up with the brillant solution of putting their inmates up for auction. Yet that is what happened at Ponteland and Lemington hospitals on Tyneside. The


Government designed that solution. If they do not like the term "privatisation", I remind them that it was a term of their own devising and implementation.
The Opposition were not responsible for a system in which two hospitals in the same city compete by fair means or foul for the right to house a new fast-track cataract surgery unit. The north and south of the Northern region, in the system that the Government devised, are locked in combat over whether the monopoly of the Freeman hospital trust can be sufficiently broken to allow the southern end of the region on Teesside to have its own heart unit. Those difficulties were of the Government's own making.
The Opposition did not devise the system in which, in an effort to save its own budget, the Freeman hospital trust required kidney patients to go and collect prescriptions from their GPs at a cost of £3·40 and bring them back to the hospital for storage. The chairman of the Freeman hospital trust, who was once in the removal business, explained matters thus:
It is not a question of the Trust avoiding necessary expenditure or endeavouring to deflect the revenue burden into the primary care sector. It is however a question of choice and determination of priorities within a given resource allocation ".
We did not devise the system whereby such short-changing in patient care can go on.
Miss D, one of my constituents, wants a cataract operation, and went for an NHS referral. She was told that she would have to wait 35 weeks for an out-patient appointment. However, Mrs. C. went to a consultant at the Freeman hospital trust, paid £25, and was told that the operation will cost £2,000, which she cannot afford. She was then accepted on the NHS waiting list for that hospital as an NHS referral. I am trying to have the £25 returned to her because, as she is an NHS referral, she is entitled to have her money back. The Opposition did not devise that system.
We also did not produce a report on the health of the nation which clearly demonstrates that a low-paid manual worker, his partner, his child and his parents will have an experience of illness dramatically different from that of people who are not low-paid manual workers. Conservative Members should bear that in mind in all our debates about low pay and a minimum wage. Attacking low pay through a minimum wage will make one of the most important contributions to the improvement of health that can possibly be made. We did not discover that information, but we have demonstrated that our policies will recover the situation and that we have the person to do it. I only wish that the opportunity which is coming our way could come a little faster.

Mr. John Carlisle: I shall not follow the line taken by the hon. Member for Newcastle upon Tyne, Central (Mr. Cousins). I represent a constituency in the North-West Thames region and agree with the view of my hon. Friend the Member for Gillingham (Mr. Couchman), reinforced by my hon. Friend the Member for Hertfordshire, South-West (Mr. Page), about money going from London to the shire counties. We have collectively been campaigning on that since I came to the House. Many London hospitals are greatly overfunded

and under-subscribed. If some of the funds and the manpower were switched from London, they might solve some of our problems.
My constituency has one of the best known hospitals adjacent to the M1—the Luton and Dunstable hospital, which, I am glad to say, has successfully applied for trust status, as has the South Bedfordshire health care unit. In the time that I have been privileged to represent them in this place, I can count on the fingers of one hand the number of letters of complaint that I have had about the hospital service. It would be foolish to say that we do not have problems, but the hospitals have a fine record, a fine body of people running them and excellent doctors and nurses. In emergencies which occur because of the hospital's proximity to that major road, the staff do a wonderful job.
It is sad that campaigns against the trust application mounted by local people, and especially by the local Labour council, have found favour in some areas. Many of the fears and smears expressed by both Opposition parties have inevitably stuck, and many untruths have been expressed in and around my constituency by those promoting their own cause.
In May, for the first time in 15 years, Luton borough council had a Labour majority, which spent more than £20,000 on an opinion poll about whether the hospitals should have trust status. Out of the total resident population of 280,000 available to the hospitals, about 40,000 people in the borough of Luton took part in the opinion poll, and the majority was 3:1 for the hospital not becoming a trust. Such a result is quite understandable, in view of the campaign mounted by the Labour party.
The main reason for that decision was ignorance, and for that, some of us on the Conservative side can take some of the blame. However, much of it was due to the political manoeuvring of the Opposition, who unashamedly played on the fears of the most needy in our population. I cannot speak for other areas, but certainly in my area the Opposition campaign was disgraceful and will rebound upon them.
Labour and Liberal parties complain that not enough consultation took place before trust status was sought, and they say that the public were not consulted. I think the Opposition have also said that the medical profession itself was not consulted. South Bedfordshire health care unit wrote to 120 doctors inviting their comments and asking them to attend a meeting. Only six doctors responded. How can they complain about not being consulted?
South Bedfordshire placed newspaper advertisements about meetings in the area and, in particular, advertising a meeting in Luton which has a population of about 150,000. Despite massive advertising, only one citizen turned up at the Luton meeting. That shows that the Opposition may be hanging their hats on a rather spurious peg, because the public have not shown the interest that we would like them to show. People have been stirred up by misinformation, especially by the Opposition.
About two years ago, when trust status was first considered, consultants, doctors, nursing staff and hospital staff expressed opposition to the idea. That was understandable, because it was unknown territory and they did not know where they were going. Some of the opposition was forthright, and was certainly made known to me. Since then, it has been accurately reported that


many consultants are in favour, and a recent expression of opinion showed that a majority are in favour. Nurses and doctors are also well on the side of trust status.
Opposition Members should note that members of the Confederation of Health Service Employees and the National Union of Public Employees have told hospital management that they are quite willing to work with them towards the trust coming to fruition next April. They also wish to be kept informed of proceedings. The Opposition think that they have everybody, including their favourite unions, on their side. Opposition Members who are sponsored by unions should go to their union bosses or, perhaps more importantly, to union members and ask them whether they are as opposed to trusts as their parliamentary representativess make them out to be. People in those unions understand that the welfare of those who work in the health service, certainly in my constituency, will be enhanced by trust status as they set their own starting levels, pay levels and conditions.
The Opposition do not seem to want to know that, for the first time in 26 years, hospitals are being returned to the people, who will control them. Through their representatives in the House and on the board, the people of Luton will be able to make known the needs of the area. Weasel words and siren voices from the Opposition will not be heard when the trusts come to fruition.
This is an exciting time for the health service; thank heavens the Government have had the courage not to throw money at the problem, as the Opposition would do, but are doing something about it. I congratulate my right hon. Friend the Secretary of State and his team on their courageous step, which will be more than welcome in my constituency and throughout the country. At the end of the day, we shall have a national health service of which we can be proud.

Mrs. Rosie Barnes: Today's debate, like that over recent weeks, has been in something of a cul-de-sac. We have all opposed privatisation, questioned whether the motive behind these reforms was privatisation and asked, if it is, whether that is a good thing and, if it is not, what should be done in its place. Hon. Members on both sides of the House have suggested that privatisation may have been high on the agenda under the former Prime Minister. I have no doubt that there has been a change in direction and I feel more comfortable about the NHS because I believe that the current Prime Minister and Secretary of State do not intend to privatise it. That does not mean that I welcome these reforms, because they are fundamentally flawed and will not take the NHS in the right direction and solve the problems that it faces.
The NHS is underfunded. We spend a lower proportion of our gross domestic product on the NHS than do the United States or most of our European counterparts. We are way behind them, and we must redress that balance.

Mrs. Ann Winterton: Is it not true that in the United States and on the continent, patients pay their own money when they go to see the doctor, while our system is free at the point of delivery and is supported by taxation?

Mrs. Barnes: Our system is largely supported through taxation, but, regrettably, charges are creeping into the system and they have to be added into the calculation.
There has to be increased funding to take account both of the increasing number of elderly people, who are expensive to treat, and improved technology. To some extent, the NHS is the victim of its own success. People are kept alive longer, so they are expensive when they are elderly, and the equipment to keep them alive is often expensive high technology. The loving care administered in the early days of the NHS required little treatment and so was much cheaper.
Therefore, it is worth reconsidering the introduction of an hypothecated tax, with a portion of income tax earmarked to go to the health service. People do not like paying tax or increases in tax. They prefer their taxes to he reduced, but there is a general agreement that they want the safety net of a health service that offers every facility when they or theirs want it. People would be prepared to pay a higher percentage of the gross domestic product towards the health service if they knew that that was where that portion of their income tax was going.
Some of the arguments about what has been described as the internal market could have been avoided. One of the first things that I did when I came here as a Member of Parliament in 1987 was to table an amendment to the Health and Medicines Bill to introduce a new form of patients' right, giving patients some control over their share of the NHS money. It would enable them to initiate the decision to go to an alternative health authority or even to the private sector, taking with them their share of the NHS money, if their health authority was not in a position to deliver the treatment that they needed within a reasonable time.
I did not think that we could promise utopia, so I suggested that the time in question should be based on what the 20 per cent. of best health authorities were delivering in the speciality. That would become the national benchmark time within which people were entitled to be treated. For example, if the top 20 health authorities were able to deliver hip replacements, where diagnosed as necessary, within five or six months, that would become the national benchmark. If a health authority could not give such treatment within that time, the patient would be entitled to make the decision to take his share of the NHS money and go elsewhere.
That form of internal market would have introduced a competitive edge into the NHS. Furthermore, the pivotal point of the decision-making process would have been not the doctor, but the patient. The decision would not be imposed on the patient. If he wanted to stay where he was and wait longer, that would be his choice. Apart from making the health service national—it is not at present —it would also have had the benefit of not destroying the doctor-patient relationship. Under the Government's proposals, the patient may feel that a decision is being imposed on him because it is the cheapest way to treat his case, not because it is the best or quickest way to do it or involves using the nearest hospital. That may not always be the case and I do not assert that all doctors work on that basis, but introducing a financial complication in the doctor-patient relationship is a regressive step.
The Government's proposals endanger the Cinderella services—geriatric and psychiatric care. The hospitals that choose to become trusts in the first and second waves may decide to push those services to one side because they are expensive and do not show up well on the economic indicators, and that will deprive the communities that they serve. I endorse further consideration of the possibility of


making whole district health authorities trusts so that some of the devolution of power, some of the autonomy and some of the decision-making can be made at more local levels, taking into consideration the total provision for everybody in the community and ensuring a proper balance of what is needed across the board. That is preferable to one hospital going for the profitable services and booting out the others.
The Government's proposals will fragment rather than integrate the health service. General practitioners and hospitals should come under one umbrella and work closely together. The present system forces them apart. Doctors try to push treatment on to the hospital budgets and hospitals try to push treatment on to doctors' budgets. A district area trust would enable them to work together more harmoniously.
I have been worried by the glee with which the London hospital review has been picked up by representatives of the shires, who have shown their conviction that London has too much hospital provision, and even a surplus. As Member of Parliament for Greenwich, I have no such experience. I find that things have got marginally worse since some of the teaching hospitals which the residents of Greenwich have traditionally used have become self-governing. Where Greenwich district health authority has a contract with hospitals such as Guy's and St. Thomas's, people are not getting treatment more swiftly and efficiently than they were under the old system.
I am not talking about the conditions that will not worsen while people wait for treatment: I am talking about treatment such as radiotherapy for breast cancer. Recently, a woman came to my surgery to tell me that she had been diagnosed as having cancer of the breast; she was told that her condition was inoperable, that radiotherapy was important and that she should start as soon as possible. On being referred to Guy's she found that there was a long waiting list for this treatment. Others have come to me with stories of how they have to wait for surgery for their kidney problems.
In the last few moments available to me, I draw the attention of the House to some research in which I was involved in the mid-1980s before I came to the House.

Madam Deputy Speaker: Order. I am sorry, but the hon. Lady has run out of time.

Mrs. Ann Winterton: It is always a pleasure to follow the hon. Member for Greenwich (Mrs. Barnes), and I hope that the intervention that she generously allowed me to make did not reduce her time. Her speech was thoughtful and constructive, and she outlined some of her reservations about the present reforms. However, in her speech one could trace several elements of common ground, not least on the issue of single trust status for a health authority district.
I am grateful for the opportunity to add my voice to the reassurances given by my right hon. Friends the Prime Minister and Secretary of State about the future of the national health service in the Government's hands. I, too, am a national health service patient and have, on the whole, received good treatment from it—with one exception, when I was the subject of negligence in the casualty department of a hospital at the time of a socialist

Administration. I have no doubt that that hospital would have said that it was understaffed and underfunded, but I am realistic enought to know that mistakes can be made and problems can occur, and that whichever party is in government will try to do its best for the health service.
It must be repeated time and again that our national health service is unique, that it is free at the point of delivery to patients in the doctor's surgery and in the hospital, and that it is maintained through taxation. I am pleased that assurances have been given that that will remain so.
The facts are undeniable, not least that the Government have increased expenditure on the national health service at 3 per cent. above the rate of inflation each year since they were elected, with the cumulative effect of an increase of more than 50 per cent. I accept—as, I believe, would everyone with any common sense—that that is not enough, nor ever could be enough, and that the introduction of reforms makes added expenditure necessary. The reorganisation process soaks up valuable funds which could be directed to patient care.
There is a commitment to the national health service. It is all well and good for other parties to say that they would change things in the future, but in the past they have never been able to generate the money and put it where their mouths are. Conservative Governments have been in office longer than any other during the lifetime of the national health service, and during that lifetime—especially in the past 12 years—there has been a tremendous increase in capital expenditure on new hospitals which were badly needed. In the Macclesfield health authority area we have benefited from a new district general hospital on which about £11·5 million has been spent.
We know that money is not everything—it is how the money is spent that is so important. The Government not only are committed to ensuring the continuation of the health service which, as we know, is dear to the hearts of every citizen, but seek to improve the service, to make it more patient-sensitive and to return decision making about local health matters to where the decisions can best be taken, which is locally.
The health service faces challenges, and there are problems that need to be tackled. Indeed, health care has changed dramatically in the past two decades. Nowadays people live longer and new techniques have been developed to improve the quality of life. One has only to talk to people who have had new hip, knee or elbow operations to know what I mean—their lives have been truly transformed. New pharmaceutical products have been developed and have played a full part in therapeutic care, and diagnostic facilities such as scanners are now widely used. All that is to be welcomed.
Professionals are being encouraged to play their part in the management of the service—consultants, doctors, nurses and midwives. I make a plea for the latter group. I believe that, in the regrading which took place before the reforms were introduced, midwives came badly unstuck. We should recognise the unique skills of the midwife and the part that she plays in caring for women before, during and after birth, and also in caring for the newborn. The midwife's expertise cannot be replaced by others, and this country needs a well recruited and trained midwifery profession which is also well remunerated in accordance with the responsibilities undertaken.
I believe that many of the fears expressed about the future of the national health service stem from the fact that


people do not understand the reforms or the way in which they are being implemented. Any change is anathema to those who do not realise that the NHS cannot be left in a fossilised state but must change to meet the challenges that I described earlier, not least the demographic changes.
Two health authorities—Crewe and Macclesfield—cover my constituency of Congleton. Leighton hospital, under Crewe health authority, was in the first wave of hospital trusts. Although not without difficulty, it has made steady progress and due to its greater flexibility it is able to respond more quickly to problems that arise. For example, the air conditioning plant in the operating theatres is at long last being tackled. That will affect the number of operations in the short term, as two theatres are out of commission while the work is being done, but it will assist in the long term and we shall not face the situation that we experienced this summer when theatre sessions were postponed because of the condition of the air and the heat.
The hospital, with its new trust status and also previously under the Crewe district health authority, has historically been underfunded because Liverpool has taken the lion's share of the resources within the Mersey regional health authority. It is not a question of the overall amount, but of how that money is allocated. That situation is being rectified and extra funding allocated to us again this year but, sadly, that funding is not coming fast enough. As in London, we wish to see a change in the way funds are given to different areas within the Mersey region.
Macclesfield health authority has expressed interest in applying for trust status in the third wave of applications, and I welcome the fact that the acute unit at the district general hospital and the community services are to go forward, I hope, as a single unit. That is a common sense approach which should greatly benefit the Congleton War Memorial hospital which lies on the periphery of the health authority area. That excellent local community hospital was founded after the first world war and was built and run by local subscription. Low-wage earners in the textile mills contributed a penny a week from their wages, and that commitment and support for the hospital is ingrained in the character of the people.
Over the years, as health care has changed, we have lost the operating theatre and the maternity unit, both of which we fought hard to retain. It should be noted that one of those facilities was lost under a socialist Administration and one under a Conservative Administration. We now believe that services to local people can be enhanced and that Congleton War Memorial hospital will play an increasingly important role in the successful provision of health care for my constituents.
I wish to mention community care briefly. Cranage Hall hospital in my constituency is a hospital home for the mentally handicapped. The Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Loughborough (Mr. Dorrell), recently visited it. I am concerned about the rate at which care in the community is being implemented. I have been to see people with a mental handicap who are now living in the community. A first-rate job is being done, and they are extremely happy. However, it must be remembered that to support those people in the community costs a huge amount of money.
Other people could also possibly benefit from living in the community, but there will always be a hard core of mentally and physically handicapped people who will have

to live in what is called an institution but which often is, or can be, a comfortable hospital home. Asylum facilities must always be retained with all the treatments which are necessary—for example, the hydropool and physioth-erapy. These facilities should be centres of excellence, and I hope that, in the plans for the future, such ideas will be taken on board and that action will be taken to ensure that those facilities are available for all handicapped people.

Mr. Martin Redmond: This afternoon, we saw the spectacle of a Secretary of State in retreat, but it was not a capitulation. It was a tactical retreat by the Secretary of State, and an attempt to confuse the issue and to confuse the public in the hope of conning them into thinking that the national health service is safe in the Government's hands.
I have said clearly from the start that the Conservative Government are after a two-tier health system, with a private element, similar to the system in the United States. Anyone who wants that system should go over there and try it: it brings pain and misery. I believe passionately in the health service, so I want to protect it for the public. Regrettably, it appears that the Conservative Government do not.
The Government talk about democracy and about informing people. Perhaps they should inform the public of their true intentions towards the health service. If they want the people to have a say, they could have supported my ten-minute Bill which called for a referendum on opt-outs, or they could test the public with a general election. That might be the way forward.
The Government have said time and again that they intend to give power back to the people. The reverse has happened, because power has come to central Government. The great pity is that there is no local democracy and no accountability. The trusts are now in total control, and the general public have no access or input to decisions made about their health. The Conservative Government talk about consulting people, but the consultation is a sham.
Only the trusts and the Secretary of State have access to the financial business plan. Neither Trent regional health authority nor the local health authority has access to the financial business plans, yet we are expected to make a decision on their viability. It is a great pity.
In the old days, Doncaster health authority had 4·5 per cent. admin costs. I was proud to be part of that. Regrettably, since the trust has taken over, the budget has yo-yoed in a way that should give the Secretary of State grave concern. The trust does not seem able to manage its finances, yet the local health authority appears to be indifferent to what is going on in relation to the trust.
It has been said that the waiting lists are coming down. I want to draw attention to the unemployment list and to the way in which the Government have fiddled the figures, which do not reflect reality. The Minister may shake his head, but there are ways in which to fiddle the figures. I am sure that the Minister is aware of that and of the fact that that is taking place. I want no shaking of heads.
It is clear that the Doncaster Royal infirmary/Montagu trust has increased admin costs. Mr. Nicholson, the chief executive, used to be on about £30,000; he is now on approximately £55,000. There is the expense of another


tier of administration, and it is disgraceful, because the money could be spent on improving the health care of patients.
When I asked about the chairman-elect of the new trust at Tickhill Road/St. Catherine's, Mr. Horsebury, I was told that he was not the chairman-elect. I lay money on the fact that he will be. When I asked Baroness Hooper about the appointment, I was told that it had been put forward by the Doncaster trust. When I asked Mike Bone, the executive officer, he said that the appointment had been put to them by the Department of Health. Either Baroness Hooper or Mike Bone is wrong. They cannot both be right. If they want to lie about silly things like that—

Madam Deputy Speaker: Order. I am sure that the hon. Gentleman realises that the word that he has just used must be withdrawn.

Mr. Redmond: I withdraw it completely, Madam Deputy Speaker. There have certainly been some misleading statements from the—

Madam Deputy Speaker: Order. "Misleading" is also an unacceptable word here.

Mr. Redmond: They have certainly conned people, Madam Deputy Speaker.
A constituent of mine in Conisborough was going for dialysis treatment to a Sheffield hospital. The group attending that session had to make their own way to the hospital by public transport. A complaint was made to me which I took up. Everyone attending the Wednesday session, bar my constituent, now has transport provided by the Sheffield hospital. He has obviously been victimised by the system for having complained to his Member of Parliament.
Another constituent has complained about the treatment that his wife gets at the Wednesday session at the new Tickhill Road/St. Catherine's trust. He has been told that his wife cannot go to the Wednesday session because the two nurses there are off sick. What is happening to treatment?
In the past, charity funds were given to the hospital for the extras—the cream on the cake. The charity funds are now being used to provide basic care, which is disgusting. The money from one fund-raising activity was not spent in the way that was intended. That may not be illegal, but it is immoral.
If the public want a guarantee about the future of the NHS, they can do only one sensible thing. They must demand a general election, vote Labour and ensure that the NHS is safe for future generations.

Mr. David Wilshire: The Labour party's performance over the past few months has been utterly sickening, and their performance this afternoon has been breathtaking in its arrogance—in the party's complete refusal to answer in clear words, or in any words, three simple questions.
What the House needs, and what the nation deserves, is the truth. The truth is this: the state of affairs in the nation is not as Labour claims. If the public are told the truth, they support the Government's proposals; if the campaigners against change tell the truth, they must admit

that their opposition to those proposals takes the form of orchestrated self-interest, rather than genuine concern for the sick and the elderly. As for the truth about NHS trusts, if people consider and discuss the facts, rather than simply trying to scare others, it will become clear that trusts will lead to better public health care for all.
Rather than swapping the kind of ill-researched generalities that the Labour party likes to use, let me try to get at the truth by referring to a case study. Ashford hospital, Middlesex, is in my constituency— [Interruption.] If hon. Members would listen, they too could get at the truth, rather than trying to blind the world with their bias.
Ashford hospital is one of the two district general hospitals in the Hounslow and Spelthorne district health authority area. When they use the hospital, its patients —my constituents —simply do not recognise the scare stories put about by the Labour party; they see those stories as fantasy. The waiting list at that hospital has been greatly reduced: it is one of the shortest in my part of south-east England, and is far shorter than it was when I became the local Member of Parliament four years ago. The hospital has the lowest costs in the area. None of us, professionals or lay people, know what the costs really were before the Government's reforms were introduced.
Let me give an example. The cost of general surgery at Ashford hospital is £887 per patient. At the other hospital in my district, the cost is £2,060. At the five other local hospitals outside my district, the highest cost is £1,400 and the lowest £1,200. Ashford hospital is significantly cheaper, and makes better use of money; but, before the reforms, we simply did not know that. My constituents now have quicker access to treatment, and about twice as many patients can be treated in a low-cost hospital as can be treated in a high-cost hospital.
Let us test Labour's claims about public opinion against the true position of Ashford hospital. Labour tells us that consultants are against the Government's proposals. Consultants at Ashford carried out a public vote: 32 were in favour of the proposals, while six opposed them. The director of nursing researched nurse opinion, and reported that 50 per cent. supported the changes, while 50 per cent. were neutral—not against.
Detailed consultation on personal issues took place with other staff. Only recently, all the portering staff were invited to take part in a discussion. The only subject that concerned them was whether their jobs were secure, not whether the proposals would benefit patients.
Then there is the question of public opinion. As the local Member of Parliament, I have received fewer than half a dozen letters opposing trust status. The community health council held a meeting, to which just 40 of my 70,000 constituents turned up. The hospital held four public meetings. At the first three, about 50 people were present; at the second, third and fourth, more than 20 who attended were the same people as before, asking the same questions; at the fourth, just 140 were there.
Seventy-three letters were written to the region about the application for trust status. In one of my local newspapers, an anti-Government pressure group admitted that it had written 67 of those letters. The group claimed that the fact that only six letters opposing the trust had been received by the region demonstrated apathy. It does not: it demonstrates the contentment of the people I represent.
Let us now test Labour's claims about the spontaneity and genuineness of opposition to trust status. I suffer from the presence in my constituency of a very vocal anti-Government pressure group—[HON. MEMBERS: "It is called the Labour party."] No, it is not the Labour party; the Labour party will be glad of that in a moment.
That pressure group claims to speak for local people about health care. But the founder of Hospital Alert, which plagues the life out of my constituents, recently spoke at an anti-Government rally of the Workers Revolutionary party, and duped a number of general practitioners into signing an anti-Government petition. She recently addressed an "all trade union alliance" conference which called for a general strike to bring down the Tory Government. That is the truth about the campaign against NHS trusts at Ashford. It is not spontaneous; it is not on behalf of the public; and it is not altruistic. It is orchestrated, it is individual and it is cynically self-seeking.
Let us test Labour's scare stories about NHS trusts against the truth at Ashford. We are all grateful to my right hon. Friend the Secretary of State for including Ashford in the second wave. As I have said, the professionals and the managers at Ashford and the lay people in my constituency have joined to support what has happened. We believe that more people will benefit from the shorter waiting lists, and more people will be treated at lower cost at Ashford as a result of trust status. Everyone in my constituency will benefit from local priorities being decided locally.
The case study that I have described shows that the truth is not as Labour claims it to be. The Government's reforms have received professional and lay support. Despite what Labour says, those reforms will produce better local services. They will make the NHS in my constituency much more public and much less private—if that is the gibe that the Labour party wants to throw about.
I believe that the country is beginning to understand clearly that my right hon. Friend the Prime Minister is telling the truth. As a Government and a party, we have improved and will continue to improve the NHS. We have no plans, and never will have plans, to privatise the NHS. That is not the truth. To claim otherwise ignores the facts that stare people in the face. If the Labour party continues to indulge in the politics of the sewer, it will reap the rewards that it justly deserves.

Rev. Martin Smyth: We all appreciated the contribution from the hon. Member for Spelthorne (Mr. Wilshire). However, I recall that one rule of logic is not to argue from the particular to the general and reach a conclusion covering all. I was glad to learn that the hon. Gentleman is happy about what is happening in Ashford, but there are concerns about the national situation.
I am delighted to be able to contribute to the debate and was pleased to see that the Minister responsible for health care in Northern Ireland was on the Government Front Bench earlier. We are talking about the national health service.
Like other hon. Members, I commit myself to the NHS. My wife and I are NHS patients and my daughter serves in the NHS. I served on the old Social Services Select Committee and I am currently a member of the Select

Committee on Health. When we carried out an objective study into NHS funding, we discovered that it was massively underfunded. At that time, we were shot down by the Government's response. I am happy to acknowledge that since then a tremendous amount of money has been poured into the health service. However, having said that, anyone who believes that the health service is as perfect as we would like it to be, is not living in the real world. I want to contribute to the debate because I am concerned that we should continue to improve the NHS.
The hon. Member for Hertfordshire, South-West (Mr. Page) dismissed the doctors' participation and called them hopeless managers, while the hon. Member for Congleton (Mrs. Winterton) welcomed the fact that we now have professionals—including doctors and nurses—in the management of the health service. I favour the view of the hon. Member for Congleton. I appreciate that not every doctor will be a good manager. However, when we moved from administrators to general management, did we significantly improve the management of the health service? I believe that we did not. In moments of cynicism I believe that we simply changed the title of "administrator" and handed several thousands of pounds more to general managers who just continued not to do the work that they should have been doing before. If people believe that no improvements can be made in the health service, they are not living in the real world.
We should not be conned into thinking that movements forward at this moment will be the panacea of all ills. I am thinking, for example of ordinary patients. A woman whom I visited in my constituency on Saturday morning has been a patient in the health service since the mid-1970s. Among other problems, she has an abscess in her breast. If only she could be operated on, as the medical folk realise the situation. The hospital sent a letter informing her that there was no bed available for her but it included a note saying that an amenity bed would be available.
I thought that that must be like Conservative party central office sending me a letter under the signature of the chairman of the Conservative party, the right hon. Member for Bath (Mr. Patten), looking for subscriptions for and membership of the Tory party. The Conservatives have only recently been prepared to organise in Northern Ireland whereas hitherto they were not. I suspect that the relevant person in the health service was travelling more on hope than on confidence that a person in a working-class home, after years of illness, could pay for an amenity bed in a national health service hospital. That. was one of the scandals of the matter.
Those who believe that hospital trusts will remedy the situation because we have management at the grass roots level may be due for a shock. Even at that level, managers may not be of the required calibre. If I may repeat the nautical metaphor used by the right hon. Member for Aylesbury (Sir T. Raison), instead of a ship being directed by the Ministry of Defence, it should be directed from the bridge. I often wonder what would have happened at Trafalgar if Nelson had not turned a blind eye to the admiral's signal.
There will be pressure. Those who opt for national health trust status have an instinct that they could be interfered with even more dramatically by directives from the Department than they have already. I trust that, in the coming weeks, hon. Members, regardless of the party that they represent, will realise that, if we make the national


health service a political football, we will discover that the general electorate—patients, practitioners and friends of patients—will give another judgment.

Mr. Robert Hayward: Time is short, so I shall be brief, but I should like to deal with a comment by the hon. Member for Belfast, South (Rev. Martin Smyth). No hon. Member believes that all is right within the health service. There are many problems in the health service in my constituency with which, unfortunately, I do not have time to deal. However, I shall refer to many of the substantial changes and improvements that I have seen in the past few years. I do that because the hon. Member for Livingston (Mr. Cook) recently came to my constituency. He did not, as would normally be the case, advise me that he intended to do so. He held a press conference outside a hospital in myconstituency—[Interruption.] Opposition Members deride that fact. They fail to recognise that, in so doing, the hon. Gentleman had alongside him the Labour candidate for my constituency, one Councillor Berry, who is leader of the Labour group on Avon council. Councillor Berry was a member of Frenshay health authority.
The Labour party consistently tells us that it is committed to the health service. Let us look at the record of Councillor Berry. He was elected to Frenshay health authority in February 1990. I have with me the minutes of Frenshay health authority for 1990. At the bottom they state, "Apologies, Dr. R. Berry." I have with me the March minutes for Frenshay health authority. [Interruption.] They do not state "apologies". They state:
The chairman welcomed Dr. Berry, who was attending the first meeting of the Authority.
He might have said that he was also attending the last meeting of the Frenshay health authority.
I say that because I have the April 1990 minutes with me, which state, "Apologies from Dr. Berry." The May 1990 minutes again state, "Apologies from Dr. Berry." The June 1990 minutes also state, "Apologies from Dr. Berry, and the July 1990 minutes again read "Apologies from Dr. Berry." Councillor Dr. Berry was absent from 83 per cent. of the health authority meetings that he was invited to attend. That is the caring Labour party. That is the person whom the hon. Member for Livingston stood alongside, saying, "We believe in and are interested in the health authority." If he is so interested in the health authority, why did Councillor Berry miss 83 per cent. of its meetings?
I should like to ask the hon. Member for Livingston and his hon. Friend the Member for Peckham (Ms. Harman), who is to reply to the debate, why no member of the shadow Treasury team was present on the Opposition Front Bench for the hon. Gentleman's speech. The answer is that they were embarrassed by the expenditure commitments, amounting to billions of pounds, that they knew that the hon. Gentleman would be likely to make. Neither the right hon. and learned Member for Monklands, East (Mr. Smith), nor the hon. Member for Derby, South (Mrs. Beckett), nor any member of the shadow Treasury team, was present for the hon. Gentleman's speech.
During the time the Conservative Government have been in power, and while I have been a Member of Parliament, the hon. Member for Livingston has visited

Cosham hospital. When there, he could have mentioned the brand new hospital at Taunton and the one at Weston-super-Mare, or the complete reconstruction of the Bristol eye hospital, all of which are just a few miles from Cosham. He could have referred to the brand new ambulance station in Soundwell road in my constituency, only 450 yd from where he was standing—I know because I measured the distance this weekend.
He could also have referred to the brand new health centre, sited right next door to the hospital at which he was speaking and which had been opened only a few months previously. He could also have walked into Cosham hospital where he would have seen a plaque commemora-ting the opening of a new ward to care for the elderly, especially those suffering from senile dementia. He would not do that, of course, because the plaque commemorated the opening of the new ward by me.
Page 5 of last Saturday's Bristol Evening Post has the headline "Hospital boost for elderly". The article states:
Keynsham hospital hopes to open its new 24-place wing for the elderly and mentally ill next summer.
Turning over the page, one sees the headline: "Hospital bosses get op theatre go-ahead". That article states:
Health chiefs have given the go-ahead for a £5 million scheme for new operating theatres at the Bristol Royal Infirmary.
That was only the day after my right hon. Friend the Secretary of State opened a new urology unit at Southmead hospital.
Yes, there are problems in the health service, but we have made enormous advances in the past few years. The benefits are there to be seen in my constituency and the immediately surrounding area by anyone who chooses to look, including the hon. Member for Livingston.
Like the vast majority of people in my constituency, I believe my right hon. Friend the Prime Minister that the health service is not being privatised. So far as I am concerned, it will not be privatised so long as I or anyone else is a patient in it. Unlike the hon. Member for Livingston, I remember 1977 when my grandfather lost his eyesight because his eye operation was cancelled. Twenty years ago, my left arm was not operated on for five hours after I had broken it, simply because an anaesthetist was not available. She had to be brought in from a party. Yes, there are problems in the health service, but we should all recognise that they have existed for a long time.

Mrs. Alice Mahon: When the Government came into office in 1979, they embarked on a strategy of privatising and selling off Britain by the pound. Privatisation takes many forms. One is to sell off good companies such as Amersham International. Another is to sell off utilities. Another is to introduce private contractors into services such as the national health service. The right hon. Member for Sutton Coldfield (Sir N. Fowler) seemed proud of it, but whatever he may say, the introduction of such private contractors has been devastating. Dedicated, hardworking domestics were sacrificed on the altar of privatisation. We were told that such efficiency savings that were made would be used to improve patient care. What absolute rubbish. Any ward sister will tell one that a domestic is an integral part of the ward team and often acts as the eyes and ears of the ward.
In the Health Select Committee, the National Childbirth Trust told us that a study which it had


conducted of women giving birth in hospitals showed an overall post-natal infection rate of 21·9 per cent. It blamed that on the standard of cleanliness in hospitals. The position is so bad that, in their anti-natal classes, the NCT teachers recommend that pregnant women take cleaning materials into hospital with them. In that case it would seem that privatisation breeds germs.
But it is in the wholesale privatisation of the care of the elderly sick that the Government have had such a spectacular success. By squeezing the district health authorities of cash and appointing their friends as chairs and managers of the DHAs, the Government have brought about a major change in health care provision for the elderly sick. It has been changed from a service free at the point of use to one in the private sector where the elderly sick or their relatives are increasingly asked to make a contribution towards their care. Who took that decision? There was no Act of Parliament, but there was a change and a hidden agenda.
In the 1980s, the Government decided that the elderly sick would be called bed blockers and that there would be no long-stay care for them. Relatives were offered lists of private nursing homes. It became impossible to get a bed, or at least to keep it, if one was elderly and sick. That is part of the Government's hidden agenda of privatisation of the NHS.
Earlier this year, Alan Templeton, the chair of Calderdale district health authority, told Calderdale community health council that it was not the responsibility of the DHA to provide long-term institutional nursing care, but that its duty was to support individuals in the community before and after episodes of medical support in hospital. Who gave him or anyone else the right to deny my elderly sick constituents an NHS hospital bed? When was it decided that after a certain age people could no longer have treatment in the NHS?
Why cannot we have NHS nursing homes? I had a case of a woman who was well into her eighties whose daughter had looked after her. Mrs. Jones had diabetes, was blind and needed daily injections. She had ulcers on her legs which needed dressing daily. She was confused and incontinent and she developed pneumonia. She needed medication, medical care, nursing care and a hospital bed. The daughter was told that no hospital bed was available. In the end a bed was found in a private nursing home. You or I would have qualified for a bed, Madam Deputy Speaker. A wicked and cynical policy has developed which redefines illness according to age, and the Government are responsible for it.
Another way to privatise the service is to starve the district health authority of funds, thus lengthening waiting lists for operations and forcing people into the private sector. That is happening increasingly with the elderly. Mr. Only, a 70-year-old pensioner, wrote to me. He had been waiting 17 months for a cataract operation. He was going blind and was told that he would have to wait another six months, but that if he was willing to pay he could have the operation done within days. That is privatisation.
In April we got the market system, based on the American system. That gave us the trusts. We all know that the Government bulldozed the trusts through Parliament. If they are still telling us that the trusts will not be privatised, why is it that the Secretary of State for Health issues circulars for action by all health authorities when it comes to infection control of deadly diseases, such as hepatitis B and HIV, yet when it comes to the trusts he

offers the circulars for information only? It is because he has relinquished power over the trusts and the trusts are one general election away from being private hospitals. They are separate bodies, and we know it.
The trusts and the market system are creating great anxiety for staff. They know that their jobs are not safe. The document "Changing Labour Utilisation in NHS Trusts" is causing anxiety to staff. Given the Government's record on privatisation, I do not believe that they do not intend to privatise the health service, and nor do the British people, who will show that at the general election.

Ms. Harriet Harman: What has been striking about this debate is that, on such an important matter as the national health service, Conservative Members have not been prepared, or have not found the courage, to speak up for their constituents—for all their constituents on waiting lists in pain and anxiety, for all their constituents who have had their operations cancelled and for all their constituents who are worried about their hospitals opting out and whose Member of Parliament refuses to listen to them.
What was striking about the speech of the Secretary of State was that it showed not a glimmer of recognition of the crisis that we all know exists in the NHS. We know, and so do patients who use the NHS, that it is being damaged by a threefold Tory attack: underfunding, commercialisation and privatisation. [HON. MEMBERS: "Rubbish."]
The Secretary of State tried to nit-pick about definitions. He attacked our candidate in Langbaurgh. He has accused us, as have his Ministers, of lying. All that that will do is convince people that the Government are refusing to face up to the crisis of underfunding and scrap the policies for which they have no mandate and not a scrap of public support. It might make the Secretary of State feel better, but it is no way for a Government in office for 12 years to defend their record.
Everyone knows, even if the Secretary of State does not, that underfunding in the NHS has caused long waiting lists. In 1979 there were 690,000 people on waiting lists. By March 1991 there were 900,000. [Interruption.] The all-party Select Committee on Health said that 23 per cent. of those waiting had been waiting for more than a year. [Interruption.] Hon. Members can howl down the figures that I have produced, but they cannot howl down the pain, anguish and misery of all those people on waiting lists.

Several Hon. Members: rose—

Madam Deputy Speaker: Order. The hon. Lady appears not to be giving way, in which case hon. Members should not persist.

Several Hon. Members: rose—

Ms. Harman: I will give way to the hon. Member for Lancaster (Dame E. Kellett-Bowman).

Dame Elaine Kellett-Bowman: Clearly the hon. Lady was not listening to the Secretary of State's opening speech. Had she been listening, she would have known that those thoroughly misleading figures that she has just given include day cases which were not totted up in those days. She is wholly wrong.

Ms. Harman: The Secretary of State and members of his party can try to sweep away the figures—[HON MEMBERS: "No."]—but if they think that by denying the figures and nit-picking over them they can change the reality of long waiting lists, of which their constituents know, they are wrong. It will not work. All it does is convince their constituents that they are out of touch.
Long waiting lists leave patients in pain and misery and force many people, reluctantly, into the private sector. Many of those who go private feel that they have no alternative if they are to escape from the pain and inconvenience of an indefinite wait for treatment. They do not feel that they are exercising their choice. They feel angry that, despite having paid through their tax and their national insurance for their health care, they cannot get the treatment when they need it. Those who cannot afford to go private feel angry, too, because they know that, if they could pay again, they could see the same doctor, in the same hospital, for the same operation, in the same week. The Secretary of State might not call that privatisation, but that is what the people who are suffering call it.
My hon. Friends the Members for Wakefield (Mr. Hinchliffe) and for Newcastle upon Tyne, Central (Mr. Cousins) have said that people are being driven into the private sector because of underfunding. That underfund-ing has caused district health authorities to cut hospital beds. No doubt the Secretary of State will deny those figures as well, but bed closures have contributed to the huge waiting lists. Since 1979, the NHS has lost 27,000 acute beds. How can it be a sign of modernisation for the NHS to cut the number of its beds but, at the same time, for the private sector to increase its number of beds?
Since 1979 the NHS has suffered the closure of 531 hospitals, the disappearance of one acute hospital bed in five, a backlog of maintenance and repairs equivalent to £1·5 billion and the cancellation of nearly 300,000 operations.

Mr. David Shaw: As a chartered accountant, I have listened with interest to the figures that the hon. Lady has quoted. Can she quote the real figure in which my constituents are interested? How much extra would a Labour Government put into the health service? Can she give us the real figure?

Ms. Harman: The difference between the next Labour Government and this Government—[HON. MEMBERS: "Answer the question."]—is that we believe that the NHS has been systematically underfunded for 12 years. We believe that that underfunding needs to be redressed, and we shall begin that task when we come into government. Even if the Government do not know that long waiting lists are causing people to be pushed into the private sector, the private health insurance companies do. They know that long waiting lists are their biggest—

Hon. Members: How much?

Mr. Speaker: Order. Let us settle down.

Ms. Harman: The private health insurance companies know that long waiting lists are forcing people into the private sector. The Secretary of State should look at the brochures of those companies; they talk about people going private because they cannot stand the pain and misery caused by long waiting lists.
The number of people going private has increased under this Government by 188 per cent., largely as a result of long waiting lists. Cash-starved district health authorities are forced into deals with private health care companies to finance new buildings and equipment that they otherwise could not afford. My hon. Friend the Member for Aberdeen, North (Mr. Hughes) quoted the example of Grampian health board, which built a 60-bed unit that now must be run by the private sector.
Today we have again discussed opting out. Once again Conservative Members have tried to peddle the myth that opting out is simply a benign form of devolved management and that no one need worry about it. That is absolute nonsense.

Mr. Thurnham: Will the hon. Lady withdraw her bogus allegation of 330,000 cancelled operations? How on earth did she arrive at that figure, which is simply a wild estimate that has been denounced by health authorities throughout the country? It is wrong, and this is a meaningless, shoddy exercise.
Ms. Harman: Those figures are absolutely accurate. If the hon. Gentleman checks Hansard for February this year he will see a question from one of my hon. Friends asking how many operations were cancelled last year. The Minister of State's answer gave a figure of about 300,000. If it was all right for the Government to calculate the figures on that basis in February, why is it not all right for us to do so in October? The only thing that has changed is that we are nearer an election and the Government are frightened.

Mr. Robert B. James: Will the hon. Lady give way?

Ms. Harman: No, I shall not give way again—

Mr. Peter Hardy: Will my hon. Friend give way?
Ms. Harman: —except to my hon. Friend.

Mr. Hardy: My hon. Friend mentioned opting out. She will be aware that the Government can have no mandate to implement opt-out in South Yorkshire. Is my hon. Friend aware that, despite the fact that the vast majority of people in South Yorkshire thought that the consultation exercise was a waste of time, the overwhelming majority of responses received on the opting out of the South Yorkshire ambulance service were strongly opposed to it? Only four organisations, consisting largely of Tory placemen, offered any support. However, the document that I suspect the Government received on that showed a fraudulent entry that was later tipp-exed out. That reduced by six the number of organisations which supported the proposal. In view of that publication, will my hon. Friend, even at this late stage, invite the Minister to reconsider that fraudulent application?

Ms. Harman: On the basis of the important point that my hon. Friend has made, I hope that the Minister will reconsider the opting out described by my hon. Friend.
People are opposed to opting out because they know that it is not just devolved management. If the Government had wanted to devolve management, they could have done so 12 years ago and it would not have needed legislation. They could have simply done it through the Department of Health. People are against opting out


because they know that it severs the link between their hospital and the local community that that hospital serves. They know that it also severs the link between hospitals and the Department of Health, which has responsibility for national strategic planning of the health service.
People are against opting out because they know that the national health service no longer owns its land or hospitals, nor employs the staff. The land, buildings, equipment and contracts of employment are passed over by statute from the Secretary of State to the boards of directors of the hospitals. Those boards of directors can decide whether to sell the land or to hire or fire the staff, and can decide what work the staff do and for whom. They can decide whether to carry out or increase private practice.
May I quote a leaked internal document from the North-West Thames regional health authority? Such documents remain secret. It says enthusiastically that, if Harefield hospital opts out, the prospects will be good for private patient work. It enthuses that opportunities may also exist to increase the work load of Harefield at the expense of other local hospitals. However, it warns that there may be a danger of a cartel, with the Brompton national heart hospital taking the work away from Harefield. That is the language of commerce and business. It is the priority of the marketplace rather than of patient care.
People know that nursing care has already been privatised with a massive public subsidy so that people who used to be able to receive care in geriatric wards or cottage hospitals have no choice but to go to private nursing homes which have been funded by the public sector. There was a 21,000 per cent. increase in the amount of public subsidy for private nursing homes between 1979 and 1990. It rose from £2·5 million in 1979 to £530 million in 1990. That money could have been spent in national health service nursing homes. People do not want to use up their life savings as they are pushed out of acute hospitals into private nursing care with no choice about where to go..
People know that dental charges are pushing dentistry out of the NHS and into the private sector. Dental charges have doubled in the past 10 years, and in some parts of the country it is difficult to find an NHS dentist who will take NHS patients. Eye tests, which provide an important screening service, must be paid for in full except by people who are means-tested or have certain conditions.
The Secretary of State would do well to recognise that it is the combination of long waiting lists, high charges, privatisation in dentistry and nursing homes, and private wings in NHS hospitals that convinces people that the NHS is under threat from the Government. It is because we are concerned about what is happening that we shall redress NHS underfunding, commercialisation and privatisation. In the lifetime of one Parliament, a Labour Government will redress the underfunding which has caused the present financial crisis in the national health service.
Performance agreements for each health authority will include the reduction of waiting lists and times. We shall set up a task force to tackle waiting list black spots and do what a Select Committee on Health wanted the Government to do, but which the Government refused: set up an investigation into the link between waiting lists and the amount of private practice. We shall bring opted-out hospitals back within district health authorities and end

the internal market in which district health authorities and hospitals have to buy and sell services. It is no good— [Interruption.]

Mr. Speaker: Order. Let us proceed in good order.

Ms. Harman: It is no good the Secretary of State or the Prime Minister making promises or declarations—people will not believe them, but will judge for themselves on their own experience. Government allegations against us will simply convince people that the Government are hopelessly out of touch.

The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell): This was the debate that the Labour party did not want to have—and from its point of view, it was entirely right, because the debate has exposed the hollowness of Labour Members' claim to be interested in the health service.
The initial effect of listening to Labour spokesmen talking about their policies reminds me of nothing so much as looking at an elaborate operatic set. The initial impact is undeniably impressive, but it relies for its effect on ingenious lighting which obscures the detail and on clever choreography which insists that the actors walk with care so as to preserve the illusion of solidity. One wrong step by any of the Labour spokesmen on that set ensures that the whole edifice collapses amid the sound of ripping canvas and splintering timber. That is the spectacle to which the House was treated earlier this afternoon.
Let us look first at underfunding. I have some sympathy with the hon. Member for Livingston (Mr. Cook). After all, he was dealt a wholly impossible brief by his shadow Cabinet colleagues. His brief was to tell the National Association of Health Authorities and Trusts that Labour promised it £4·5 billion, at the same time as telling the British Medical Association that Labour promised it £6 billion, at the same time as the right hon. and learned Member for Monklands, East (Mr. Smith) was going around the prawn cocktail circuit saying that Labour made no pledge at all about health expenditure.
Today, the hon. Member for Livingston finally crashed off the set that he had created and let the cat out of the bag. He committed Labour on expenditure in the following words: "We have done it before, and we will do it again just like last time." As my hon. Friend the Member for Northampton, South (Mr. Morris) reminded us, those are chilling words indeed to anyone on an NHS waiting list or looking for care in an NHS hospital.
I will remind the hon. Gentleman what "just like last time" means. Last time, Labour increased health expenditure by 3·1 per cent. on average in real terms each year it was in office. Three per cent. is a figure to which the Labour party appears to be attached, because in the 1987 general election the Leader of the Opposition, the person so touchingly referred to yesterday by the hon. Member for Livingston as the ultimate authority, their leader, committed the Labour party in the course of this Parliament to increasing expenditure on health by 3 per cent. per year in real terms.
The problem for the hon. Gentleman is that 3·1 per cent., the record between 1974 and 1979 and the commitment of the Leader of the Opposition at the last election, is precisely the record of this Government every


year since 1979. Despite all the alarums and excursions, the hon. Member for Livingston has failed to open any difference between his commitments and our record.
I do not dispute for one moment what the hon. Gentleman and his predecessors between 1974 and 1979 would like to have done. The difficulty was that the International Monetary Fund refused to pay the bill. The hon. Gentleman's commitment is to do it again just like last time, but the real issue, as my right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) reminded us, is not money—it is management.

Mr. Geoffrey Lofthouse: Will the Minister give way?

Mr. Dorrell: Once, and then no more.

Mr. Lofthouse: Is the hon. Gentleman aware that consultants at Pontefract general infirmary informed me that they have been warned by the health authority not to "over-market"? They must leave room to attract customers from outside the authority's area so as to attract money. Is he further aware that I recently received a letter from three consultants informing me that, due to underfunding, my constituents are receiving what they describe as sub-standard service? Does he not believe them?

Mr. Dorrell: Before leaving the subject of underfund-ing, I will simply observe that a party which says that we are underfunding the health service should have an idea of the amount of the underfunding. It should also give a clear commitment to the electorate about what it would do about underfunding if elected to government.
The hon. Member for Livingston suggests that we should study the record of the Labour Government of 1974–79. I am happy to do so. I shall look at the way in which resources have been used in the health service. Those resources grew at exactly the same rate between 1974 and 1979 as they have grown under this Government since 1979.
Between 1974 and 1979, in-patient treatments rose at an average yearly rate of less than 1 per cent. Since 1979, they have risen at an average of more than 2 per cent. per year. Between 1974 and 1979, in-patient waiting lists rose by nearly half—by 48 per cent. Since 1979, they have fallen by 8 per cent. Between 1974 and 1979, bearing in mind that resources grew at the same rate in that Parliament as they have done since, capital expenditure on new health equipment and buildings in the NHS fell by 28 per cent. Since 1979, that same capital expenditure has risen by 68 per cent. As my right hon. Friend the Member for Sutton Coldfield rightly said, the issue is management—how resources are used within the national health service.
I shall now deal with the issues raised by the hon. Member for Peckham (Ms. Harman)—

Mr. Bob Cryer: Will the hon. Gentleman give way?

Mr. Dorrell: I am sure that the hon. Gentleman will wish to sit down so that I can answer the questions asked by his hon. Friend.
The hon. Member for Peckham expressed concern about the decline in the number of acute beds in the national health service. I will read an extract from The Times, which states:
Some press reports have given the impression that hospital closures are evidence that our health service is being run down and is doing less for patients … That is just not true, in many cases new and efficient buildings are replacing antiquated ones … I make no apology for the policy of closing hospitals that are no longer needed. Under-used beds cost money that could be better spent elsewhere.
Those are not my words but the words of Lord Ennals when he held the office now held by my right hon. Friend the Secretary of State.
The 1974–79 Labour Government recognised, as we have recognised, that a modern health service needs fewer acute beds to treat more patients. Under Labour, acute bed space fell by 1·2 per cent. per annum between 1974 and 1979 for exactly the same reason as it has continued to fall since 1979.
The key question is how Labour, if elected to office, would improve the management of the national health service. Labour Front Bench spokesmen have shown precious little interest in that issue. They prefer to spread the privatisation smear, even though they now recognise that the smear does not work. They started by saying that we intend to privatise the health service. They have been convinced that that smear is unworkable and now want to use the growth of charges to create the impression of what they are pleased to call creeping privatisation. That charge does not work either, because my right hon. Friend has drawn attention to an inconvenient detail—that a policy of creeping privatisation by extending charging would be against the law.
The legislation under which the NHS works is perfectly clear. Section 1(2) of the National Health Service Act 1977 states:
The services so provided shall be free of charge except in so far as the making and recovery of charges is expressly provided for by
that or another enactment. Three specific enactments allow charges, the first being the prescription charge which, as someone rightly said, was introduced by Labour. Secondly, there are opticians' and dentists' charges—also introduced by Labour. So far, that is 2:0 to Labour. Thirdly, charges for eye tests were introduced in 1988. By my mathematics, the extension of charging falls 2:1 to Labour.
Nothing daunted, the Labour Front Bench spokesmen went on to talk about nursing home charges, and nursing homes are an important issue. I had thought that the policy in the White Paper "Caring for People" was a bipartisan one. The Labour party is explicitly committed to supporting it, and it is under that policy that those who need nursing care are provided with it, in the community, in private sector nursing homes. That policy has abolished a waiting list that we inherited in 1979—that for part III accommodation, social care in local authorities.
The Labour party cannot accept the principle of any provision of any sort of care that is not provided in the public sector. Exactly the same principle informs its approach to pay beds. It now pursues a policy of removing pay beds from the health service, which would cut by £100 million the resources available for patient care.

Mr. Brian Wilson: Will the hon. Gentleman give way?

Mr. Dorrell: No.
The Labour party is also committed to a mimimum wage policy which will result in a further cut of £400 million in the resources available for patient care. It is committed to abolishing market testing, which will cut the amount available for patient care by £50 million.

Mr. Cryer: Will the hon. Gentleman give way?

Mr. Dorrell: No. Then there will be—[Interruption.]

Mr. Speaker: Order. Hon. Members must resume their seats, because the Minister has shown that he will not give way.

Mr. Dorrell: —a further cut of £300 million. That is £750 million-worth of cuts in patient care to which the Labour party is committed, and will introduce if it comes into office.
The hon. Member for Livingston made it clear yesterday that he remains committed to the absurd proposal of flexi-budgets, a proposal that my right hon. Friend the Secretary of State has rightly described as an unworkable mess. The Labour party has not thought it through and is not convincing. The one thing that is clear about flexi-budgets is that they would mean a return to funding health care institutions, rather than funding health authorities to buy the health care for the people in their areas. That will be of interest to those of my hon. Friends who represent constituencies that stand to gain from weighted capitation. My right hon. Friends the Members for Blackpool, South (Sir P. Blaker) and for Finchley (Mrs. M. Thatcher) and my hon. Friends the Members for Calder Valley (Mr. Thompson), for Norwich, North (Mr. Thompson, for Dudley, West (Dr. Blackburn), for Chorley (Mr. Dover) and for Bolton, North-East (Mr. Thurnharn) all stand to lose as a result of the proposal to abolish weighted capitation.
Labour's policies are all of a piece. As my right hon. Friend the Member for Sutton Coldfield said, the Labour party has been consistent since 1979—it has opposed change and then accepted it. It opposed the sale of council houses, trade union reform and every cut in the standard rate of income tax. Now, it is Labour policy not to let the standard rate rise. As my right hon. Friend said, it opposed general managers in the NHS, the limited list and market testing, although it had introduced that in Liverpool. They are a good Opposition. They have learnt how to run scare stories without committing themselves, but to govern is to choose and they are unfit to govern because they are unwilling to choose.

Question put, That the amendment be made:—

The House divided: Ayes 209, Noes 303.

Division No. 231
[10 pm


AYES


Adams, Mrs Irene (Paisley, N.)
Benton, Joseph


Allen, Graham
Bermingham, Gerald


Anderson, Donald
Bidwell, Sydney


Archer, Rt Hon Peter
Blunkett, David


Armstrong, Hilary
Boateng, Paul


Ashley, Rt Hon Jack
Boyes, Roland


Ashton, Joe
Bradley, Keith


Banks, Tony (Newham NW)
Bray, Dr Jeremy


Barnes, Harry (Derbyshire NE)
Brown, Gordon (D'mline E)


Barnes, Mrs Rosie (Greenwich)
Brown, Nicholas (Newcastle E)


Battle, John
Brown, Ron (Edinburgh Leith)


Bell, Stuart
Caborn, Richard


Benn, Rt Hon Tony
Callaghan, Jim


Bennett, A. F. (D'nt'n &amp; R'dish)
Campbell, Ron (Blyth Valley)





Campbell-Savours, D. N.
Lestor, Joan (Eccles)


Canavan, Dennis
Lewis, Terry


Clark, Dr David (S Shields)
Litherland, Robert


Clarke, Tom (Monklands W)
Livingstone, Ken


Clay, Bob
Lloyd, Tony (Stretford)


Clelland, David
Lofthouse, Geoffrey


Clwyd, Mrs Ann
Loyden, Eddie


Cohen, Harry
McAllion, John


Cook, Robin (Livingston)
McAvoy, Thomas


Corbett, Robin
McCartney, Ian


Corbyn, Jeremy
Macdonald, Calum A.


Cousins, Jim
McFall, John


Cox, Tom
McKay, Allen (Barnsley West)


Crowther, Stan
McKelvey, William


Cryer, Bob
McLeish, Henry


Cummings, John
McMaster, Gordon


Cunliffe, Lawrence
McNamara, Kevin


Cunningham, Dr John
McWilliam, John


Darling, Alistair
Madden, Max


Davies, Rt Hon Denzil (Llanelli)
Mahon, Mrs Alice


Davies, Ron (Caerphilly)
Marek, Dr John


Davis, Terry (B'ham Hodge H'I)
Marshall, David (Shettleston)


Dewar, Donald
Marshall, Jim (Leicester S)


Dixon, Don
Martin, Michael J. (Springburn)


Dobson, Frank
Martlew, Eric


Douglas, Dick
Meacher, Michael


Dunwoody, Hon Mrs Gwyneth
Meale, Alan


Eadie, Alexander
Michie, Bill (Sheffield Heeley)


Eastham, Ken
Mitchell, Austin (G't Grimsby)


Edwards, Huw
Molyneaux, Rt Hon James


Evans, John (St Helens N)
Moonie, Dr Lewis


Ewing, Harry (Falkirk E)
Morgan, Rhodri


Field, Frank (Birkenhead)
Morris, Rt Hon A. (W'shawe)


Fields, Terry (L'pool B G'n)
Morris, Rt Hon J. (Aberavon)


Fisher, Mark
Mowlam, Marjorie


Flannery, Martin
Mullin, Chris


Flynn, Paul
Murphy, Paul


Foot, Rt Hon Michael
Nellist, Dave


Foster, Derek
Oakes, Rt Hon Gordon


Foulkes, George
O'Brien, William


Fraser, John
O'Hara, Edward


Fyfe, Maria
O'Neill, Martin


Galloway, George
Orme, Rt Hon Stanley


Garrett, John (Norwich South)
Owen, Rt Hon Dr David


Garrett, Ted (Wallsend)
Parry, Robert


Gilbert, Rt Hon Dr John
Patchett, Terry


Godman, Dr Norman A.
Pendry, Tom


Golding, Mrs Llin
Pike, Peter L.


Gordon, Mildred
Prescott, John


Gould, Bryan
Primarolo, Dawn


Graham, Thomas
Quin, Ms Joyce


Grant, Bernie (Tottenham)
Radice, Giles


Griffiths, Nigel (Edinburgh S)
Randall, Stuart


Griffiths, Win (Bridgend)
Redmond, Martin


Hain, Peter
Rees, Rt Hon Merlyn


Hardy, Peter
Reid, Dr John


Harman, Ms Harriet
Richardson, Jo


Hattersley, Rt Hon Roy
Robertson, George


Haynes, Frank
Robinson, Geoffrey


Heal, Mrs Sylvia
Rogers, Allan


Henderson, Doug
Rooker, Jeff


Hinchliffe, David
Rooney, Terence


Hoey, Kate (Vauxhall)
Ross, Ernie (Dundee W)


Hogg, N. (C'nauld &amp; Kilsyth)
Ross, William (Londonderry E)


Home Robertson, John
Rowlands, Ted


Howarth, George (Knowsley N)
Ruddock, Joan


Howell, Rt Hon D. (S'heath)
Sedgemore, Brian


Hoyle, Doug
Sheerman, Barry


Hughes, John (Coventry NE)
Sheldon, Rt Hon Robert


Hughes, Robert (Aberdeen N)
Shore, Rt Hon Peter


Hughes, Roy (Newport E)
Short, Clare


Ingram, Adam
Sillars, Jim


Janner, Greville
Skinner, Dennis


Jones, Barry (Alyn &amp; Deeside)
Smith, Andrew (Oxford E)


Jones, Martyn (Clwyd S W)
Smith, C. (Isl'ton &amp; F'bury)


Kaufman, Rt Hon Gerald
Smith, Rt Hon J. (Monk'ds E)


Kilfoyle, Peter
Smith, J. P. (Vale of Glam)


Lambie, David
Smyth, Rev Martin (Belfast S)


Leadbitter, Ted
Snape, Peter


Leighton, Ron
Soley, Clive






Steinberg, Gerry
Williams, Rt Hon Alan


Stott, Roger
Williams, Alan W. (Carm'then)


Strang, Gavin
Wilson, Brian


Straw, Jack
Winnick, David


Taylor, Mrs Ann (Dewsbury)
Wise, Mrs Audrey


Thompson, Jack (Wansbeck)
Worthington, Tony


Turner, Dennis
Wray, Jimmy


Vaz, Keith
Young, David (Bolton SE)


Walley, Joan



Wardell, Gareth (Gower)
Tellers for the Ayes:


Wareing, Robert N.
Mr. Ray Powell and


Welsh, Michael (Doncaster N)
Mr. Eric Illsley.


Wigley, Dafydd





NOES


Adley, Robert
Davis, David (Boothferry)


Aitken, Jonathan
Day, Stephen


Alison, Rt Hon Michael
Devlin, Tim


Allason, Rupert
Dickens, Geoffrey


Amery, Rt Hon Julian
Dicks, Terry


Amess, David
Dorrell, Stephen


Arbuthnot, James
Douglas-Hamilton, Lord James


Arnold, Jacques (Gravesham)
Dover, Den


Arnold, Sir Thomas
Dunn, Bob


Ashby, David
Durant, Sir Anthony


Aspinwall, Jack
Eggar, Tim


Atkins, Robert
Emery, Sir Peter


Atkinson, David
Evans, David (Welwyn Hatf'd)


Baker, Nicholas (Dorset N)
Evennett, David


Baldry, Tony
Fairbairn, Sir Nicholas


Batiste, Spencer
Fallon, Michael


Beaumont-Dark, Anthony
Farr, Sir John


Bellingham, Henry
Fenner, Dame Peggy


Bendall, Vivian
Field, Barry (Isle of Wight)


Bennett, Nicholas (Pembroke)
Finsberg, Sir Geoffrey


Bevan, David Gilroy
Fishburn, John Dudley


Bitten, Rt Hon John
Fookes, Dame Janet


Blackburn, Dr John G.
Forth, Eric


Blaker, Rt Hon Sir Peter
Fowler, Rt Hon Sir Norman


Body, Sir Richard
Fox, Sir Marcus


Bonsor, Sir Nicholas
Franks, Cecil


Boswell, Tim
Freeman, Roger


Bottomley, Peter
French, Douglas


Bottomley, Mrs Virginia
Fry, Peter


Bowden, A. (Brighton K'pto'n)
Gale, Roger


Bowden, Gerald (Dulwich)
Gardiner, Sir George


Bowis, John
Gill, Christopher


Boyson, Rt Hon Dr Sir Rhodes
Gilmour, Rt Hon Sir Ian


Braine, Rt Hon Sir Bernard
Glyn, Dr Sir Alan


Brandon-Bravo, Martin
Goodlad, Alastair


Brazier, Julian
Goodson-Wickes, Dr Charles


Bright, Graham
Gorman, Mrs Teresa


Brown, Michael (Brigg &amp; Cl't's)
Gorst, John


Bruce, Ian (Dorset South)
Grant, Sir Anthony (CambsSW)


Buck, Sir Antony
Greenway, Harry (Ealing N)


Budgen, Nicholas
Greenway, John (Ryedale)


Burns, Simon
Gregory, Conal


Burt, Alistair
Griffiths, Peter (Portsmouth N)


Butcher, John
Grist, Ian


Butler, Chris
Ground, Patrick


Carlisle, John, (Luton N)
Grylls, Michael


Carlisle, Kenneth (Lincoln)
Hamilton, Neil (Tatton)


Carrington, Matthew
Hampson, Dr Keith


Cash, William
Hanley, Jeremy


Chalker, Rt Hon Mrs Lynda
Hannam, John


Channon, Rt Hon Paul
Hargreaves, A. (B'ham H'll Gr')


Chapman, Sydney
Hargreaves, Ken (Hyndburn)


Chope, Christopher
Harris, David


Churchill, Mr
Hawkins, Christopher


Clark, Rt Hon Alan (Plymouth)
Hayes, Jerry


Clark, Dr Michael (Rochford)
Hayhoe, Rt Hon Sir Barney


Clark, Rt Hon Sir William
Hayward, Robert


Clarke, Rt Hon K. (Rushcliffe)
Heath, Rt Hon Edward


Conway, Derek
Heathcoat-Amory, David


Coombs, Anthony (Wyre F'rest)
Heseltine, Rt Hon Michael


Coombs, Simon (Swindon)
Hicks, Mrs Maureen (Wolv' NE)


Cope, Rt Hon Sir John
Higgins, Rt Hon Terence L.


Couchman, James
Hill, James


Currie, Mrs Edwina
Hind, Kenneth


Davies, Q. (Stamf'd &amp; Spald'g)
Hogg, Hon Douglas (Gr'th'm)





Hordern, Sir Peter
Oppenheim, Phillip


Howard, Rt Hon Michael
Page, Richard


Howarth, Alan (Strat'd-on-A)
Paice, James


Howarth, G. (Cannock &amp; B'wd)
Parkinson, Rt Hon Cecil


Howell, Rt Hon David (G'dford)
Patnick, Irvine


Howell, Ralph (North Norfolk)
Patten, Rt Hon John


Hughes, Robert G. (Harrow W)
Pattie, Rt Hon Sir Geoffrey


Hunt, Rt Hon David
Pawsey, James


Hunt, Sir John (Ravensbourne)
Porter, Barry (Wirral S)


Hunter, Andrew
Porter, David (Waveney)


Irvine, Michael
Portillo, Michael


Irving, Sir Charles
Powell, William (Corby)


Jack, Michael
Price, Sir David


Jackson, Robert
Raison, Rt Hon Sir Timothy


Janman, Tim
Redwood, John


Jessel, Toby
Renton, Rt Hon Tim


Jones, Gwilym (Cardiff N)
Rhodes James, Sir Robert


Jones, Robert B (Herts W)
Riddick, Graham


Keilett-Bowman, Dame Elaine
Ridley,Rt Hon Nicholas


Key, Robert
Rifkind, Rt Hon Malcolm


King, Roger (B'ham N'thfield)
Roberts, Rt Hon Sir Wyn


King, Rt Hon Tom (Bridgwater)
Roe, Mrs Marion


Kirkhope, Timothy
Rossi, Sir Hugh


Knapman, Roger
Rost, Peter


Knight, Greg (Derby North)
Rowe, Andrew


Knowles, Michael
Rumbold, Rt Hon Mrs Angela


Knox, David
Ryder, Rt Hon Richard


Lamont, Rt Hon Norman
Sackville, Hon Tom


Lang, Rt Hon Ian
Sayeed, Jonathan


Latham, Michael
Scott, Rt Hon Nicholas


Lawrence, Ivan
Shaw, David (Dover)


Lee, John (Pendle)
Shaw, Sir Giles (Pudsey)


Leigh, Edward (Gainsbor'gh)
Shelton, Sir William


Lennox-Boyd, Hon Mark
Shephard, Mrs G. (Norfolk SW)


Lester, Jim (Broxtowe)
Shephard, Colin (Hereford)


Lloyd, Sir Ian (Havant)
Shepherd, Richard (Aldridge)


Lloyd, Peter (Fareham)
Shersby, Michael


Lord, Michael
Sims, Roger


Luce, Rt Hon Sir Richard
Skeet, Sir Trevor


MacGregor, Rt Hon John
Smith, Sir Dudley (Warwick)


MacKay, Andrew (E Berkshire)
Smith, Tim (Beaconsfield)


Maclean, David
Soames, Hon Nicholas


McLoughlin, Patrick
Speed, Keith


McNair-Wilson, Sir Michael
Speller, Tony


McNair-Wilson, Sir Patrick
Spicer, Sir Jim (Dorset W)


Malins, Humfrey
Spicer, Michael (S Worcs)


Mans, Keith
Squire, Robin


Maples, John
Stanbrook, Ivor


Marland, Paul
Stanley, Rt Hon Sir John


Marshall, John (Hendon S)
Steen, Anthony


Marshall, Sir Michael (Arundel)
Stern, Michael


Martin, David (Portsmouth S)
Stevens, Lewis


Mates, Michael
Stewart, Allan (Eastwood)


Maude, Hon Francis
Stewart, Andy (Sherwood)


Mawhinney, Dr Brian
Stewart, Rt Hon Sir Ian


Maxwell-Hyslop, Robin
Stokes, Sir John


Mayhew, Rt Hon Sir Patrick
Sumberg, David


Mellor, Rt Hon David
Summerson, Hugo


Miller, Sir Hal
Taylor, Ian (Esher)


Mills,Iain
Taylor, Sir Teddy


Miscampbell, Norman
Tebbit, Rt Hon Norman


Mitchell, Andrew (Gedling)
Temple-Morris, Peter


Mitchell, Sir David
Thompson, D. (Calder Valley)


Moate, Roger
Thompson, Patrick (Norwich N)


Montgomery, Sir Fergus
Thorne, Neil


Moore, Rt Hon John
Thurnham, Peter


Morris, M (N'hampton S)
Tracey, Richard


Morrison, Sir Charles
Tredinnick, David


Morrison, Rt Hon Sir Peter
Trippier, David


Moss, Malcolm
Trotter, Neville


Mudd, David
Twinn, Dr Ian


Neale, Sir Gerrard
Vaughan, Sir Gerard


Nelson, Anthony
Viggers, Peter


Neubert, Sir Michael
Waldegrave, Rt Hon William


Newton, Rt Hon Tony
Walden, George


Nicholls, Patrick
Walker, Bill (T'side North)


Nicholson, David (Taunton)
Waller, Gary


Nicholson, Emma (Devon West)
Ward, John


Norris, Steve
Wardle, Charles (Bexhill)


Onslow, Rt Hon Cranley
Watts, John






Wells, Bowen
Wood, Timothy


Wheeler, Sir John
Woodcock, Dr. Mike


Whitney, Ray
Yeo, Tim


Widdecombe, Ann
Young, Sir George (Acton)


Wilkinson, John



Wilshire, David
Tellers for the Noes:


Winterton, Mrs Ann
Mr. David Lightbown and


Wolfson, Mark
Mr. John M. Taylor.

Question accordingly negatived.

Main Question put:—

The House divided: Ayes 301, Noes 224.

Division No. 232]
[10.15pm


AYES


Adley, Robert
Davies, Q. (Stamfd &amp; Spald'g)


Aitken, Jonathan
Davis, David (Boothferry)


Alison, Rt Hon Michael
Day, Stephen


Allason, Rupert
Devlin, Tim


Amery, Rt Hon Julian
Dickens, Geoffrey


Amess, David
Dicks, Terry


Arbuthnot, James
Dorrell, Stephen


Arnold, Jacques (Gravesham)
Douglas-Hamilton, Lord James


Arnold, Sir Thomas
Dover, Den


Ashby, David
Dunn, Bob


Aspinwall, Jack
Durant, Sir Anthony


Atkins, Robert
Eggar, Tim


Atkinson, David
Emery, Sir Peter


Baker, Nicholas (Dorset N)
Evans, David (Welwyn Hatf'd)


Baldry, Tony
Evennett, David


Batiste, Spencer
Fairbairn, Sir Nicholas


Beaumont-Dark, Anthony
Fallon, Michael


Bellingham, Henry
Farr, Sir John


Bendall, Vivian
Fenner, Dame Peggy


Bennett, Nicholas (Pembroke)
Field, Barry (Isle of Wight)


Bevan, David Gilroy
Finsberg, Sir Geoffrey


Biffen, Rt Hon John
Fishburn, John Dudley


Blackburn, Dr John G.
Fookes, Dame Janet


Blaker, Rt Hon Sir Peter
Forth, Eric


Body, Sir Richard
Fowler, Rt Hon Sir Norman


Bonsor, Sir Nicholas
Fox, Sir Marcus


Boswell, Tim
Franks, Cecil


Bottomley, Peter
Freeman, Roger


Bottomley, Mrs Virginia
French, Douglas


Bowden, A. (Brighton K'pto'n)
Fry, Peter


Bowden, Gerald (Dulwich)
Gale, Roger


Bowis, John
Gardiner, Sir George


Boyson, Rt Hon Dr Sir Rhodes
Gill, Christopher


Braine, Rt Hon Sir Bernard
Gilmour, Rt Hon Sir Ian


Brandon-Bravo, Martin
Glyn, Dr Sir Alan


Brazier, Julian
Goodlad, Alastair


Bright, Graham
Goodson-Wickes, Dr Charles


Brown. Michael (Brigg &amp; Cl't's)
Gorman, Mrs Teresa


Bruce, Ian (Dorset South)
Gorst, John


Buck, Sir Antony
Grant, Sir Anthony (CambsSW)


Budgen, Nicholas
Green way, Harry (Ealing N)


Burns, Simon
Greenway, John (Ryedale)


Burt, Alistair
Gregory, Conal


Butcher, John
Griffiths, Peter (Portsmouth N)


Butler, Chris
Grist, Ian


Carlisle, John, (Luton N)
Ground, Patrick


Carlisle, Kenneth (Lincoln)
Grylls, Michael


Carrington, Matthew
Hamilton, Neil (Tatton)


Cash, William
Hampson, Dr Keith


Chalker, Rt Hon Mrs Lynda
Hanley, Jeremy


Channon, Rt Hon Paul
Hannam, John


Chapman, Sydney
Hargreaves, A. (B'ham H'll Gr')


Chope, Christopher
Hargreaves, Ken (Hyndburn)


Churchill, Mr
Harris, David


Clark, Rt Hon Alan (Plymouth)
Hawkins, Christopher


Clark, Dr Michael (Rochford)
Hayes, Jerry


Clark, Rt Hon Sir William
Hayhoe, Rt Hon Sir Barney


Clarke, Rt Hon K. (Rushcliffe)
Hayward, Robert


Conway, Derek
Heath, Rt Hon Edward


Coombs, Anthony (Wyre F'rest)
Heathcoat-Amory, David


Coombs, Simon (Swindon)
Heseltine, Rt Hon Michael


Cope, Rt Hon Sir John
Hicks, Mrs Maureen (Wolv' NE)


Couchman, James
Higgins, Rt Hon Terence L.


Currie, Mrs Edwina
Hill, James





Hind, Kenneth
Norris, Steve


Hogg, Hon Douglas (Gr'th'm)
Onslow, Rt Hon Cranley


Hordern, Sir Peter
Oppenheim, Phillip


Howard, Rt Hon Michael
Page, Richard


Howarth, Alan (Strat'd-on-A)
Paice, James


Howarth, G. (Cannock &amp; B'wd)
Parkinson, Rt Hon Cecil


Howell, Rt Hon David (G'dford)
Patnick, Irvine


Howell, Ralph (North Norfolk)
Patten, Rt Hon John


Hughes, Robert G. (Harrow W)
Pattie, Rt Hon Sir Geoffrey


Hunt, Rt Hon David
Pawsey, James


Hunt, Sir John (Ravensbourne)
Porter, Barry (Wirral S)


Hunter, Andrew
Porter, David (Waveney)


Irvine, Michael
Portillo, Michael


Irving, Sir Charles
Powell, William (Corby)


Jack, Michael
Price, Sir David


Jackson, Robert
Raison, Rt Hon Sir Timothy


Janman, Tim
Redwood, John


Jessel, Toby
Renton, Rt Hon Tim


Jones, Gwilym (Cardiff N)
Rhodes James, Sir Robert


Jones, Robert B (Herts W)
Riddick, Graham


Kellett-Bowman, Dame Elaine
Rifkind, Rt Hon Malcolm


Key, Robert
Roberts, Rt Hon Sir Wyn


King, Roger (B'ham N'thfield)
Roe, Mrs Marion


King, Rt Hon Tom (Bridgwater)
Rossi, Sir Hugh


Kirkhope, Timothy
Rost, Peter


Knapman, Roger
Rowe, Andrew


Knight, Greg (Derby North)
Rumbold, Rt Hon Mrs Angela


Knowles, Michael
Ryder, Rt Hon Richard


Knox, David
Sackville, Hon Tom


Lamont, Rt Hon Norman
Sayeed, Jonathan


Lang, Rt Hon Ian
Scott, Rt Hon Nicholas


Latham, Michael
Shaw, David (Dover)


Lawrence, Ivan
Shaw, Sir Giles (Pudsey)


Lee, John (Pendle)
Shelton, Sir William


Leigh, Edward (Gainsbor'gh)
Shephard, Mrs G. (Norfolk SW)


Lennox-Boyd, Hon Mark
Shepherd, Colin (Hereford)


Lester, Jim (Broxtowe)
Shepherd, Richard (Aldridge)


Lloyd, Sir Ian (Havant)
Shersby, Michael


Lloyd, Peter (Fareham)
Sims, Roger


Lord, Michael
Skeet, Sir Trevor


Luce, Rt Hon Sir Richard
Smith, Sir Dudley (Warwick)


MacGregor, Rt Hon John
Smith, Tim (Beaconsfield)


MacKay, Andrew (E Berkshire)
Soames, Hon Nicholas


Maclean, David
Speed, Keith


McLoughlin, Patrick
Speller, Tony


McNair-Wilson, Sir Michael
Spicer, Sir Jim (Dorset W)


McNair-Wilson, Sir Patrick
Spicer, Michael (S Worcs)


Malins, Humfrey
Squire, Robin


Mans, Keith
Stanbrook, Ivor


Maples, John
Stanley, Rt Hon Sir John


Marland, Paul
Steen, Anthony


Marshall, John (Hendon S)
Stern, Michael


Marshall, Sir Michael (Arundel)
Stevens, Lewis


Martin, David (Portsmouth S)
Stewart, Allan (Eastwood)


Mates, Michael
Stewart, Andy (Sherwood)


Maude, Hon Francis
Stewart, Rt Hon Sir Ian


Mawhinney, Dr Brian
Stokes, Sir John


Maxwell-Hyslop, Robin
Sumberg, David


Mayhew, Rt Hon Sir Patrick
Summerson, Hugo


Mellor, Rt Hon David
Taylor, Ian (Esher)


Miller, Sir Hal
Taylor, Sir Teddy


Mills,Iain
Tebbit, Rt Hon Norman


Miscampbell, Norman
Temple-Morris, Peter


Mitchell, Andrew (Gedling)
Thompson, D. (Calder Valley)


Mitchell, Sir David
Thompson, Patrick (Norwich N)


Moate, Roger
Thorne, Neil


Montgomery, Sir Fergus
Thurnham, Peter


Moore, Rt Hon John
Tracey, Richard


Morris, M (N'hampton S)
Tredinnick, David


Morrison, Sir Charles
Trippier, David


Morrison, Rt Hon Sir Peter
Trotter, Neville


Moss, Malcolm
Twinn, Dr Ian


Mudd, David
Vaughan, Sir Gerard


Neale, Sir Gerrard
Viggers, Peter


Nelson, Anthony
Waldegrave, Rt Hon William


Neubert, Sir Michael
Walden, George


Newton, Rt Hon Tony
Walker, Bill (T'side North)


Nicholls, Patrick
Waller, Gary


Nicholson, David (Taunton)
Ward, John


Nicholson, Emma (Devon West)
Wardle, Charles (Bexhill)






Watts, John
Wood, Timothy


Wells, Bowen
Woodcock, Dr. Mike


Wheeler, Sir John
Yeo, Tim


Whitney, Ray
Young, Sir George (Acton)


Widdecombe, Ann



Wilkinson, John
Tellers for the Ayes:


Wilshire, David
Mr. David Lightbown and


Winterton, Mrs Ann
Mr. John M. Taylor.


Wolfson, Mark





NOES


Adams, Mrs Irene (Paisley, N.)
Ewing, Harry (Falkirk E)


Allen, Graham
Fearn, Ronald


Alton, David
Field, Frank (Birkenhead)


Anderson, Donald
Fields, Terry (L'pool B G'n)


Archer, Rt Hon Peter
Fisher, Mark


Armstrong, Hilary
Flannery, Martin


Ashdown, Rt Hon Paddy
Flynn, Paul


Ashley, Rt Hon Jack
Foot, Rt Hon Michael


Ashton, Joe
Foster, Derek


Banks, Tony (Newham NW)
Foulkes, George


Barnes, Harry (Derbyshire NE)
Fraser, John


Barnes, Mrs Rosie (Greenwich)
Fyfe, Maria


Battle, John
Galloway, George


Beith, A. J.
Garrett, John (Norwich South)


Bell, Stuart
Garrett, Ted (Wallsend)


Bellotti, David
Gilbert, Rt Hon Dr John


Benn, Rt Hon Tony
Godman, Dr Norman A.


Bennett, A. F. (D'nt'n &amp; R'dish)
Golding, Mrs Llin


Benton, Joseph
Gordon, Mildred


Bermingham, Gerald
Gould, Bryan


Bidwell, Sydney
Graham, Thomas


Blunkett, David
Grant, Bernie (Tottenham)


Boateng, Paul
Griffiths, Nigel (Edinburgh S)


Boyes, Roland
Griffiths, Win (Bridgend)


Bradley, Keith
Hain, Peter


Bray, Dr Jeremy
Hardy, Peter


Brown, Gordon (D'mline E)
Harman, Ms Harriet


Brown, Nicholas (Newcastle E)
Hattersley, Rt Hon Roy


Brown, Ron (Edinburgh Leith)
Haynes, Frank


Caborn, Richard
Heal, Mrs Sylvia


Callaghan, Jim
Henderson, Doug


Campbell, Ron (Blyth Valley)
Hinchliffe, David


Campbell-Savours, D. N.
Hoey, Kate (Vauxhall)


Canavan, Dennis
Hogg, N. (C'nauld &amp; Kilsyth)


Carlile, Alex (Mont'g)
Home Robertson, John


Can, Michael
Howarth, George (Knowsley N)


Clark, Dr David (S Shields)
Howell, Rt Hon D. (S'heath)


Clarke, Tom (Monklands W)
Howells, Geraint


Clay, Bob
Hoyle, Doug


Clelland, David
Hughes, John (Coventry NE)


Clwyd, Mrs Ann
Hughes, Robert (Aberdeen N)


Cohen, Harry
Hughes, Roy (Newport E)


Cook, Robin (Livingston)
Hughes, Simon (Southwark)


Corbett, Robin
Ingram, Adam


Corbyn, Jeremy
Janner, Greville


Cousins, Jim
Jones, Barry (Alyn &amp; Deeside)


Cox, Tom
Jones, Martyn (Clwyd S W)


Crowther, Stan
Kaufman, Rt Hon Gerald


Cryer, Bob
Kennedy, Charles


Cummings, John
Kilfoyle, Peter


Cunliffe, Lawrence
Kirkwood, Archy


Cunningham, Dr John
Lambie, David


Darling, Alistair
Leadbitter, Ted


Davies, Rt Hon Denzil (Llanelli)
Leighton, Ron


Davies, Ron (Caerphilly)
Lestor, Joan (Eccles)


Davis, Terry (B'ham Hodge H')
Lewis, Terry


Dewar, Donald
Litherland, Robert


Dixon, Don
Livingstone, Ken


Dobson, Frank
Livsey, Richard


Douglas, Dick
Lloyd, Tony (Stretford)


Dunwoody, Hon Mrs Gwyneth
Lofthouse, Geoffrey


Eadie, Alexander
Loyden, Eddie


Eastham, Ken
McAllion, John


Edwards, Huw
McAvoy, Thomas


Evans, John (St Helens N)
McCartney, Ian





Macdonald, Calum A.
Robinson, Geoffrey


McFall, John
Rogers, Allan


McKay, Allen (Barnsley West)
Rooker, Jeff


McKelvey, William
Rooney, Terence


McLeish, Henry
Ross, Ernie (Dundee W)


Maclennan, Robert
Ross, William (Londonderry E)


McMaster, Gordon
Rowlands, Ted


McNamara, Kevin
Ruddock, Joan


McWilliam, John
Sedgemore, Brian


Madden, Max
Sheerman, Barry


Mahon, Mrs Alice
Sheldon, Rt Hon Robert


Marek, Dr John
Shore, Rt Hon Peter


Marshall, David (Shettleston)
Short, Clare


Marshall, Jim (Leicester S)
Sillars, Jim


Martin, Michael J. (Springburn)
Skinner, Dennis


Martlew, Eric
Smith, Andrew (Oxford E)


Meacher, Michael
Smith, C. (Isl'ton &amp; F'bury)


Meale, Alan
Smith, Rt Hon J. (Monk'ds E)


Michie, Bill (Sheffield Heeley)
Smith, J. P. (Vale of Glam)


Mitchell, Austin (G'f Grimsby)
Smyth, Rev Martin (Belfast S)


Molyneaux, Rt Hon James
Snape, Peter


Moonie, Dr Lewis
Soley, Clive


Morgan, Rhodri
Steel, Rt Hon Sir David


Morris, Rt Hon A, (W'shawe)
Steinberg, Gerry


Morris, Rt Hon J. (Aberavon)
Stott, Roger


Mowlam, Marjorie
Strang, Gavin


Mullin, Chris
Straw, Jack


Murphy, Paul
Taylor, Mrs Ann (Dewsbury)


Nellist, Dave
Thompson, Jack (Wansbeck)


Oakes, Rt Hon Gordon
Turner, Dennis


O'Brien, William
Vaz, Keith


O'Hara, Edward
Wallace, James


O'Neill, Martin
Walley, Joan


Orme, Rt Hon Stanley
Warden, Gareth (Gower)


Owen, Rt Hon Dr David
Wareing, Robert N.


Parry, Robert
Welsh, Michael (Doncaster N)


Patchett, Terry
Wigley, Dafydd


Pendry, Tom
Williams, Rt Hon Alan


Pike, Peter L.
Williams, Alan W. (Carm'then)


Prescott, John
Wilson, Brian


Primarolo, Dawn
Winnick, David


Quin, Ms Joyce
Wise, Mrs Audrey


Radice, Giles
Worthington, Tony


Randall, Stuart
Wray, Jimmy


Redmond, Martin
Young, David (Bolton SE)


Rees, Rt Hon Merlyn



Reid, Dr John
Tellers for the Noes:


Richardson, Jo
Mr. Ray Powell and


Robertson, George
Mr. Eric Illsley.

Question accordingly agreed to.

Resolved,
That this House welcomes the record extra resources provided for the NHS and the substantial increase in the number of NHS patients treated since the Government came to office in 1979; supports the Government's reforms of the NHS which are already bringing about improvements in patient care; deplores the intellectual bankruptcy of Her Majesty's Opposition which, bereft of any coherent proposals of its own for the modernisation of the National Health Service, is reduced to peddling smears and scares which lower morale amongst NHS staff and cause wholly unnecessary fear amongst patients; notes with approval the Prime Minister's unequivocal statement on the NHS that there will be no charges for hospital treatment, no charges for visits to the doctor, no privatisation of health care, neither in part nor as a whole, now or in the future; and welcomes his unequivocal assurance that Trust hospitals remain a permanent part of the NHS.

BUSINESS OF THE HOUSE

Ordered,
That, at this day's sitting, the Lords Amendment to the British Technology Group Bill may be proceeded with, though opposed, until any hour.—[Mr. Boswell.]

Orders of the Day — British Technology Group Bill

Lords amendment considered.

Lords amendment: After clause 6, insert the following new clause—Offers for sale of securities—
Where an offer for sale of any securities of the successor company is to be made by or on behalf of the Crown or any invitation or advertisement is to be issued by or on behalf of the Crown in connection with the offer, the Secretary of State shall consult such persons appearing to him to be representative of the universities of the United Kingdom as he considers appropriate.

Read a Second time.

Mr. Speaker: With this we will take amendments (a), (b) and (c) to the Lords amendment, and consequent Government amendments Nos. 1 and 2.

Dr. Lewis Moonie: I beg to move, as an amendment to the Lords amendment, amendment (a): in line 6, after 'universities', insert 'and research councils'.
We remain implacably opposed to the principles behind the Bill. We believe that it is ill conceived, and poses a real danger for the future of the British Technology Group. However, that is not the substance of our discussion tonight. I have to recognise that the House has already made its decision on the British Technology Group Bill. It therefore remains only for us to consider the Lords amendment and to see in what way it might be improved.
The Lords amendment, a cross-Bench amendment, was carried last week. As we can see from the amendment paper, the Government have agreed to accept it. It offers a small concession from the Government on the safeguards surrounding the sale that we attempted to have built into the Bill—that, before offering for sale any securities in the successor company
the Secretary of State shall consult such persons appearing to him to he representative of the universities of the United Kingdom as he considers appropriate.
The purpose of our amendment is merely to tease out some additional concessions from the Government. As they have been decent enough to accept this small amendment, they might be broad-spirited enough to consider some further improvements to the Bill.
Our amendment (a) seeks to insert "and research councils" after universities. That is self-explanatory. We seek to broaden slightly, and only slightly, the terms of consultation which have already been agreed in principle. In amendment (b) we have attempted to specify some of the information about which universities should he consulted. After all, in theory it is possible for the Government to phone the Committee of Vice-Chancellors and Principals, tell it that they are selling securities and call that consultation. I am sure that, being a decent man, the Under-Secretary would not dream of doing anything so underhand and out of keeping with the spirit of the Lords amendment. Nevertheless, we feel that it would be valuable to add this additional safeguard.
Amendment (c) is also self-explanatory. We feel that the Secretary of State ought to allow a reasonable period for consultation on the Bill and have suggested a period of three months to allow the Bill to be gone into in proper detail.
Much of the argument in Committee, in both this House and another place, dealt with the independence, integrity and impartiality of the British Technology Group following any privatisation. To some extent, the Government have met those concerns. Indeed, in Committee I remember the Under-Secretary saying clearly that he intended to safeguard those three important principles. He appears to have done so in two ways. One is by certain inclusions in the articles of association. He has certainly tried to do so. The other is by accepting the Lords amendment.
I should be grateful if he would spend a few minutes looking at those principles in tandem with the articles of association and explain to the House how he feels that his objectives have been achieved. There was no disagreement on those objectives in Committee, merely considerable discussion of how they might be achieved.
In conclusion, I reiterate that we are opposed to the sale in principle. Should the Bill not go through before a change of Government, which happily will occur in the next six months, we will certainly reverse the proposal. If the reports in the press are accurate, it may well be that a rather more interventionist Secretary of State is about to be chosen to see out the twilight of this Administration, in which case we might see changes in the Bill before then. Who knows? I am sure that neither the Minister for Corporate Affairs nor the Under-Secretary of State would welcome that. I ask that Under-Secretary to give some explanation of how he thinks that those important safeguards have been handled.

The Parliamentary Under-Secretary of State for Industry and Consumer Affairs (Mr. Edward Leigh): I am grateful for the constructive spirit in which the hon. Member for Kirkcaldy (Dr. Moonie) moved his amendment. He is right that there is no agreement on the principle of privatisation, but that matter has been well aired in this Chamber, and we do not need to go over that ground again. Both sides of the Chamber are united in the firm hope that the impartiality, independence and integrity of the British Technology Group can be retained. I give a commitment on behalf of the Government that we are fully committed to those three Is. The concessions made in the House of Lords will allay any residual concerns in those areas.
The hon. Gentleman mentioned the articles of association. There are two key provisions in the articles of association protected by the special share. These are, first, a 15 per cent. limit on individual shareholdings, which will continue in the articles even after the special share is redeemed at the end of five years. The Government will be prepared to consider higher individual shareholdings, should that prove necessary, to attract the right consortium, but we are looking at a benchmark of some 15 per cent. The second is a restriction on substantial disposals of assets above a certain level—25 per cent. of net assets or of the income raised by the assets disposed —without the special shareholder's consent.
In addition, there are two further safeguards in the articles of association. The first is a provision for one director of the company to be directly appointed by the universities in consultation with the polytechnics. The universities will thus have the power of appointment to the board, in contrast with the current situation, in which universities have no right of representation on the present board. Secondly, one director, in addition to the


Committee of Vice-Chancellors and Principals, shall be someone who appears to the members to have wide experience in the commercialisation of public sector research. Those will be entrenched in the articles of association. In my judgment and the Government's. there is no doubt that those provisions, entrenched in the articles and protected by the special share held by the Government, will preserve the impartiality, independence and integrity of the BTG.
As the hon. Gentleman said, we accept the amendment proposed by Lord Flowers in another place. It will ensure that there is full consultation with the universities. We believe that the hon. Gentleman's amendments are unnecessary. Amendment (a) would require the Secretary of State to consult the research councils. I should draw the attention of the House to the role of Government research councils. They have historically provided the BTG with a small proportion of its inventive ideas. In the year ending 31 March 1991, about 10 per cent. of new inventions accepted by the BTG came from this source, compared with around 50 per cent. from the academic sector.
I hope that the hon. Member for Kirkcaldy will accept that the fact that we have accepted the Lords amendment, and will ensure that there is proper consultation with the universities, will meet any concern that might exist.
Amendments (b) and (c) attempt to set out some of the details of the kind of consultation which the Secretary of State must conduct with the universities and to fix a three-month period for that to occur. The Government do not consider that that is appropriate. We will conduct proper consultation with the universities before any offer for sale is made. We will certainly ensure that there is sufficient time for them to make representations and for us to consider them.
We do not believe that it will be in the interests of the long-term viability of the BTG to extend the consultation period over a fixed three months. I can only assume that there is something else behind the amendments—that the Opposition are attempting to delay full privatisation beyond next spring. I cannot understand why. If one was solely concerned with the future of the BTG—there is considerable interest in the country in purchasing it as a viable entity—on should reject the amendments.

Dr. Moonie: Implicit in that statement is the suggestion that the BTG will be privatised immediately. Is that the case?

Mr. Leigh: There will be a full consultation period. I cannot give a firm date when privatisation will take place. As soon as Royal Assent is received, an information memorandum will be issued. I can tell the House that considerable interest has been expressed in purchasing the BTG. We are confident that we will find a purchaser or purchasers who will ensure that the impartiality, independence and integrity of the BTG is maintained.
I cannot give a firm date when the privatisation will take place, but I hope that it will be some time in the new year or shortly after.

Mr. Simon Hughes: The Minister and his colleagues will be aware that I, in common with the hon. Member for Kirkcaldy (Dr. Moonie), have been extremely sceptical from the outset about the interests and motivations of the Government.
We believe that the Government consider the BTG to he yet another publicly owned asset which, for dogmatic reasons rather than anything else, they want to privatise.
It is welcome that at least the cross-Bench proposal —described as minimalist—was approved by their Lordships. That will lead to some consultation with the universities. Effectively, that has been the only concession wrung out of the Government by electoral defeat. However, I am glad that they have not sought to overturn that in the fag-end of the parliamentary Session.
On the amendments, although the Minister has sought to say that the research councils have a lesser share of BTG business that does not invalidate the point that they should be the subject of consultation. As a result of the amendment in the other place, which the Government now recommend to us to accept, there will he consultation with the universities. However, that does not exclude the advantage of consultation with the research councils as well. The Minister's answer did not deal with that point effectively.
The amendments seek to ensure that the consultation exercise is wider and longer than it might otherwise have been. That is the risk behind the procedure. I accept that one normally would not specify that the details of consultation should be contained in legislation. However, the danger is that the Government will proceed more quickly than would be wise even if one accepted the premise of their privatisation proposal. The Minister did not deal with that problem. My party, in common with the Labour party, does not accept that premise.
I accept that the Government made some concessions in the other place on the articles of association, and dealt with some of the concern about the independence and integrity of the BTG being sustained. The large bulk of the employees of the BTG work in my constituency. Apart from the senior management, those employees have never been persuaded that the privatisation proposal was in their best interests. so those concessions on the articles of association arc welcome. The fact that there will be some-protection and that the BTG will not be sold off wholesale to one interest is at least progress. It appears that the argument has been won.
However, it will be unfortunate if the Government do not accept the amendments tabled tonight. They do nothing disadvantageous but give some protection, and they would be welcomed by the employees. They would not be disadvantageous to the British Technology Group or the public interest. Therefore, although the Minister's initial response was to resist them, I hope that he will accept them in the same way as the Government have accepted the principal Lords amendment before us, which provides for consultation. Our scepticism, however, remains. We think that the Government are wrong and, if the opportunity arises, we—like the Labour party—would seek to change the course that the Government are piloting for the BTG. We hope that that opportunity will arise. In the meantime, I hope that the Government will accept that the amendments have been tabled in good faith and will, even at this late stage, accept them.

Dr. Jeremy Bray: The Minister is right to say that a number of the points that Labour Members have argued on Second Reading and in Committee were subsequently accepted in the Lords, and


that some of them have been embodied in the published articles of association. However, I am surprised that he has not continued in that spirit in reply to our amendments to the Lords amendments before us tonight. They were tabled in good faith with the intention of serving the purpose of an efficient future for the British Technology Group.
It may be true that, in the past and until now, the research councils have directly accounted for only a relatively small proportion of the IPR that has come to BTG. However, I should he surprised if the Department of Trade and Industry, of all Departments, were to take the view that that would necessarily he so in the future. Does he value the link programme so little that the joint interest between the Minister's Department and the Science and Engineering Research Council might not produce a more abundant supply of IPR which BTG might wish to consider in the future?
As for the scope of the consultation, I expected the Minister to stand up and say, "Yes, of course we shall consult on those matters. It would only be common sense to do so. It is not necessary to put it into the legislation, but it is certainly our intention, in safeguarding the integrity and impartiality of the BTG, that there should be scope for consultation." There is a practical reason for this: there have been reports, confirmed in a sense by the Minister, that more than one group is interested in bidding for BTG. However, the universities have been approached by only one potential group, and they have no knowledge of what other bidders may be in the market.
Surely the Minister sees that it would be in the DTI's interest and the interests of the future of the BTG, for the universities to be properly consulted about the bids that are received. In recognising that one might well be more closely associated with the universities than others, it is not beyond the wishes of the Minister and his Department to handle such consultations. It need not be a sensitive matter but may be related to the acceptability of the partners, what is known about them, and so on. A vast fund of knowledge exists within the universities and the research councils, which I should have thought the Minister would want to tap.
Had we wished to table a blocking amendment, the period would not have been three months but six months or a year. Had our intention been to wreck the Bill, you, Mr. Speaker, would not have selected the amendments for consideration, because they would have been out of order. So it is a bona fide point that there are substantial issues on which practical consultation is needed about the nature of the Bill, particularly given the concessions that the Government have made—the special share, the 15 per cent. holding and the disposal of more than 25 per cent. All those factors point to a desire to carry with BTG the support of the public in the higher education and research council sectors.
Therefore, even if the Minister is not of a mind to accept the amendment—I understand the procedural complications that that might cause, because, if the amendment were to return to the Lords further amended tomorrow, that might lead to delays and embarrassment for the Government—surely, in view of the worries felt in the universities and research community, the Minister could say that it was his intention to conduct consultations in the manner and with the scope suggested in the amendments.

Mr. Leigh: I am grateful to the hon. Members for Southwark and Bermondsey (Mr. Hughes) and for Motherwell, South (Dr. Bray). We believe that the universities can he taken as representatives of the whole research community. That point was made by Lord Flowers in another place, when he moved the original Lords amendment.
I shall remind the House of the figures that I gave previously. As the hon. Member for Motherwell said, they might change but as a benchmark they provide useful information. In the year ending 31 March, about 10 per cent. of new inventions accepted by the BTG came from research councils, compared with about 50 per cent. from the academic sector. Therefore, the universities are in a wholly predominant position, and enjoy a unique relationship with the BTG. We do not believe that it is necessary to make similar provisions in the Bill for other interest groups.

Dr. Bray: Is the Minister saying that the universities, which were the source of the proposals, were not funded by the research councils in any of the research leading to their proposals?

Mr. Leigh: I can only repeat what I said, which I think was absolutely clear. We were rightly told that the universities have a predominant role in BTG's affairs. They provide BTG with about 50 per cent. of its inventions. Lord Flowers told us that the universities can represent the research councils in the consultations. Therefore, we accept the amendment in a spirit of conciliation.
If we were to accept the logic of what the hon. Member for Motherwell, South said, we would have to broaden the further consultation provided for by the Bill to include a raft of other interested parties, including private sector companies, investors, management and employees, polytechnics and licensees—all of which have legitimate interests. We have listened to representations on the Bill made to us while formulating our policy on the special share provisions. However, we do not intend to include special provisions in the Bill to consult all those groups, because it simply would not be feasible to do so.
Timing was mentioned by the hon. Members for Motherwell, South and for Southwark and Bermondsey. We believe that a period as long as three months is neither necessary or possible. The best way to explain the subject to allay any fears—particularly those expressed by the hon. Member for Southwark and Bermondsey—is that the consultation process will not be rushed. It will take as long as is required—no longer and no less. With good will on both sides, it need not be a process that takes months rather than weeks to resolve.
Preparations for the sale are well advanced, and there are a large number of potentially interested parties. Therefore, it would send the wrong message to the market and have a prejudicial effect on the sale if there were now to be a three-month hiatus in the privatisation process to allow for consultation. I hope that I can reassure the hon. Gentleman that there will be proper consultation, but it would in no way aid the group's future as an organisation maintaining impartiality, independence and integrity if there were to be a three-month hiatus.
The hon. Member for Motherwell, South said that the privatisation of the BTG was ideologically driven. The BTG already operates on a fully commercial basis. It is


entirely self-financing and profitable, with no Government subsidy. It no longer enjoys the right of first refusal on public sector inventions. It has been competing for this business since 1985. Lastly, and most importantly—this meets the charge that our privatisation is merely ideologically driven and not concerned with the better management and future of this organisation—its current public sector status restricts the commercial freedom of the business and has restricted its development, especially overseas.
We believe it right not for ideological reasons but for the future of this group, for its impartiality, independence and integrity, that we should complete the process tonight which will, incidentally, result in the abolition of the National Enterprise Board.

Dr. Bray: Does the Minister intend to consult the universities on any bids received, given the universities' right to nominate a director to the board?

Mr. Leigh: No, because the universities may place a bid themselves. We have taken great care to allay all their

concerns. I met the Committee of Vice-Chancellors and Principals, as did my noble Friend Lord Rea. It is very possible that the universities may want to bid for a share in this consortium. In that event, it would be inappropriate to give preferential treatment to the universities in the bidding process. We will be bound by this Lords amendment—I hope that the House will accept it in a few moments' time—at the time when the memorandum of information is sent out, to consult the universities on it and on the advertisements associated with it. That will reassure the universities that we intend to continue the constructive dialogue that we have held with them on this issue in recent months.

Dr. Moonie: We are not very happy with the Minister's reassurances, but I see no point in pursuing the matter. I therefore beg to ask leave to withdraw the amendment.

Amendment, to the Lords amendment, by leave, withdrawn.

Lords amendment agreed to.

Consequent Government amendments Nos. I and 2 agreed to.

Orders of the Day — Aid to Developing Countries

[Relevant documents: European Community Documents Nos. 6515/190 relating to guidelines for co-operation with developing countries in Asia and Latin America and 7576/91 relating to generalised tariff preferences for certain products originating in Costa Rica, Honduras, El Salvador, Guatemala, Nicaragua and Panama.]

Mr. Bowen Wells: On a point of order, Mr. Deputy Speaker. How much time do we have to debate this order; and why was it not considered, as recommended by the Select Committee on European Legislation, by European Standing Committee B?

Mr. Deputy Speaker (Sir Paul Dean): We have one and a half hours to debate the order, if that much time is required. On the other point, apparently the House voted accordingly.

The Minister for Overseas Development (Mrs. Lynda Chalker): I beg to move,
That this House takes note of European Community Document Nos. 4051/91 and the Supplementary Explanatory Memoranda submitted by the Overseas Development Administration on 18th and 25th February 1991, and 5896/91 + COR I. relating to financial co-operation with developing countries in Asia and Latin America; and endorses the Government's policy on Community aid to Asian and Latin American countries.
The motion invites the House to take note of two documents, 4051/91 and 5896/91. The first is a Commission communication to the Council proposing guidelines for technical and financial co-operation with the developing countries of Latin America and Asia during the period 1991 to 1995. The second is a proposed regulation on the same them. If a regulation is adopted by the Council, the guidelines will become redundant. This we hope to do at the Development Council on 28 November.
The earlier draft. 4051/91, was deposited with an explanatory memorandum on 8 February, and a supplementary explanatory memorandum on 25 February. The second document, 5896/91, was deposited with an explanatory memorandum on 5 June. There was a previous Commission communication, document 6515/90, which the Select Committee on European Legislation also considered relevant for debate. It is therefore tagged to this motion. However, it has been overtaken by events. It was a general policy paper entitled "Guidelines for Cooperation with Developing Countries of Latin America and Asia". One further document is tagged to this debate: the Commission's recent proposals on the tariff preferences for certain products originating in central America, Document 7576/91. I will come to this later.
Since the United Kingdom joined the EC, British Governments of both parties have supported a global EC development programme going beyond the African Caribbean and Pacific countries covered by the Lome Convention. These documents do not deal with aid to Lome countries, of which there are now 69, nor does it cover food aid, on which about £120 million per year is spent for Asia and Latin America alone. It concerns only the EC's programme of aid to Asia and Latin America —the ALA programme—started in 1976. A Council regulation of February 1981, adopted after five years of discussion, gave it a clear focus on the poorest countries and on the needs of rural areas.
Implementation has since then been governed by annual guidelines. In December 1990, the Council of Ministers agreed a five-year framework figure for development aid to Asia and Latin America of £1·92 billion or 2·75 billion ecu. The documents propose the basis on which that money should be allocated.
Asia and Latin America are regions of great importance to us. They include major trading partners, both dynamic growing economies in the Pacific rim and our more traditional partners such as India, Pakistan and Bangladesh. They are regions of great political signifi-cance, with many countries especially in Latin America emerging from murky military regimes to the light of democracy. They also contain a large proportion of the world's poorest people and environmentally sensitive forests and savannahs. It is therefore right that we should accord them a high place in the EC's external relations.

Dr. Norman A. Godman: I agree with almost everything that the Minister has said, especially about murky military regimes. Will she assure the House that agricultural exports, especially the export of tropical fruit from Latin America, will not harm the interests of Caribbean producers? As the Minister knows, many banana producers are now small family farms in the Windward Islands and elsewhere. The Germans do not appear to give a damn about such producers. May we be assured that those producers' interests will not be harmed by the developments that the Minister outlines?

Mrs. Chalker: I can give the hon. Gentleman that assurance. He and my hon. Friend the Member for Hertford and Stortford (Mr. Wells) will know how hard we have worked to try to get a proper regime for Caribbean countries, which are the main suppliers of bananas to the British market. It would be wrong to go into more detail, but I assure the hon. Gentleman that the subject of bananas is never far from my desk, and we shall discuss it further in the future.

Mr. Jacques Arnold: Will my right hon. Friend bear in mind that the Commonwealth Caribbean countries should not rely on our good will and supply us with inferior quality bananas? Will she note that a much higher quality of banana is obtainable from the republics of central America, which in many ways also deserve our good will?

Mrs. Chalker: I should be in your bad books, Mr. Deputy Speaker, if I went into the subject of the quality of bananas at this point in the debate, but I assure hon. Members that the aims of our bilateral aid programme in the Caribbean, which is not covered by these documents, are not only to improve the quality of the produce of all the dependencies, such as the Windward Islands, but to encourage diversification into other products. Without diversification, all banana growers, whether in the Caribbean, central America, Latin America, Asia or Africa, will be in difficulties.

Mr. Jeremy Corbyn: Watch out for the skins.

Mrs. Chalker: The hon. Gentleman is too kind.
In 1989, largely at United Kingdom insistence, the Commission produced an evaluation of the 13 years of its ALA programme. At the Development Council in November 1989 I insisted that we should maintain the


poverty focus of the programme, increase the role of women in its projects, and make it more sensitive to environmental concerns. I am glad to say that the Council agreed. It was in response to those conclusions that the Commission produced the documents which are the subject of tonight's motion.
The new Development Council policy shows a number of welcome improvements. For example, it has been a goal of British Government policy under Governments of both parties to secure a basis for EC aid to Asia and Latin America which allows for coherent planning of aid in each of the major recipient counties. Hence, we welcome the creation of a multi-annual programme, which should allow more effective aid programmes linked to the implementation of development policies by the Governments concerned.
We also welcome the way in which aid is to be tailored to the varied needs of recipients. The Commission documents refer to two axes: development aid for poor countries and population groups, and economic cooperation with more advanced countries and sectors. For the latter countries, economic co-operation, with its emphasis on trade and the private sector, is clearly the right approach. We have been in the forefront of the pressure for greater access to markets of the developed world, for more effective support for the development of the private sector, and in the promotion of the right climate to encourage investment.
For this to work, there must be a real prospect of markets for the goods produced. We have therefore argued very strongly for an open and liberal trade regime through the general agreement on tariffs and trade, GATT, and continue to believe that this is the best mechanism to advance the development of all economies. Trade is more effective than aid as an engine of growth, and contributes much more income to the developing nations.
However, for poor countries, that trade engine may need help to get started. Aid on concessional terms is vital to help build the infrastructure, both physical and human, that the private sector needs to grow. We also have a duty to seek to alleviate the acute poverty that blights so many lives in these countries. I have repeatedly emphasised the importance that we attach to improving the position of women. Women bear most of the burden of poverty in these countries and we must continually seek to design our aid to meet their needs. For example, we are contributing £6 million and the EC a similar amount to the Chitral rural support project in Pakistan, in which, alongside the Aga Khan Foundation, we aim to help women improve their skills, participate in decision making, and gain genuine control over their lives.
We have therefore worked hard in the negotiations on the new ALA programme to maintain the poverty focus of the development aid axis, so that grant aid goes where it is most needed. We have also pressed hard for a high priority for the needs of women. We expect to succeed in both areas. Our partners now see the crucial importance of these dual focuses.
The conservation of the environment is another key theme of British aid policy. The 1990 Houston summit charged the Commission, together with the World bank, with developing a programme to conserve the Amazon rain forest. Earlier this year, I visited forest areas in Brazil

and saw for myself both the scale of the need and the contribution that we are making through our bilateral aid programme there. We have already launched six forestry projects, and appointed a forestry expert to make sure these are effective and to design more projects there. However, the theme is too large for any single donor, so we have argued strongly for a substantial proportion—at least 10 per cent.—of the EC's ALA programme to be set aside for projects specifically to conserve the environment throughout both regions.
We have also pressed for a special place to be given to the fight against drugs. This is a scourge of most regions of Asia and Latin America. We have ensured that there is a special place made in the regulation for aid to combat drug production and trafficking. We therefore welcomed the allocation of 60 million ecu—about £40 million—to the worst affected countries of the Andean region last year. These countries were also accorded special treatment under the Community's trade preference system for developing countries, the generalised system of prefer-ences. Since we do not wish to dilute that advantage, we have reservations about extending the same benefits to central America, as proposed in the Commission proposal 7576/91 which is tagged to this debate.
We believe that human rights and good government are fundamental to the success of development.

Mr. D. N. Campbell-Savours: My hon. Friend the Member for Cynon Valley (Mrs Clwyd) has done some interesting work on the question of renewables and how they could be slotted into the aid programme. Does the Commission have a view on the extent to which the export of renewables technology to third-world countries might be further developed? Do the Government have a view on these matters?

Mrs. Chalker: I can answer for my Department. We are examining that question to see where it can fit and where it will work. A country has to have a certain ability to accept and utilise such exports before they are sent. I am not aware that the Commission has taken a position on the issue, but I will check and write to the hon. Gentlemen.
I said that I believe that human rights and good government are fundamental to the success of overseas development. My right hon. Friend the Prime Minister made a clear and powerful statement of our views on this topic in Harare last week at the Commonwealth Heads Of Government meeting. It is critical to look at the broader policy environment when considering aid allocations. For example, are the institutions to which the aid is being directed effective, open and accountable? What are the democratic processes? Does the country respect human rights and the rule of law? Answers to questions of that kind indicate whether resources are being used effectively. They also help to tell whether the recipients are, in fact, committed to those goals in the context of their own societies.
Where improvements can be encouraged, there are positive measures that we can take. These include support for the legal sector, customs, police, public administration, accounting and audit, and a free press. On the other hand, while it is right to emphasise the help that we can give to those who wish to move forward, in cases where the abuse of human rights is serious, we have to be prepared to redesign or withdraw support. That is true for the ALA programme but, of course, it also goes much wider.

Mr. Wells: Are the Government's broad policy aims shared by the European Community? How can my right hon. Friend ensure that, if they are, they are enforced through the policies of the European Community?

Mrs. Chalker: My hon. Friend anticipates my next comments.
The Dutch presidency is preparing operational guidelines on "Human Rights, Democracy and Development", and we must ensure that these threads are sewn into all Community aid. My discussion with our 11 partners in Holland in July this year was open and first class, and I believe that all countries are prepared to follow the lead that we have given in aid policy. We are also negotiating clear provisions in the ALA regulation in particular. That is very important, because it means that we are starting with the ALA regulations as we mean to go on.
Good government is essential for aid programmes to be effective, but there are other aspects of effectiveness, and here again we are pressing hard for improvements. The United Kingdom's share of the EC aid programme Corms an integral and important part of our overall aid programme, and we work for high quality in it as we do for all our aid. I have to say that I do not believe that the Commission's systems are yet up to our standards, but we have seconded a number of staff to build them up. We are also working to improve monitoring and evaluation procedures in the Community.
The House will have noted that the second draft was a good deal better than the first. At least in part, that is due to our efforts. We now await a further revised proposal which, I trust, will he better again.

Mr. Peter Bottomley: My right hon. Friend will have noticed the comment in the explanatory memorandum, which states:
the new proposal does not accurately reflect the conclusions which were reached at Council.
Can she share with the House her opinion on whether that refers to an insignificant mistake that we are now pointing out or whether it was a result of deliberate confusion? In the administration of a programme, it strikes me as rather important to translate Ministers' wishes at the Council into what is put before the European Community.

Mrs. Chalker: As so often happens in some of these discussions, there is a good reason for improving the draft. I will check on my hon. Friend's point. As far as my memory serves me, it was a question of improving the draft. There was nothing sinister behind it.

Mr. William Cash: Has my right hon. Friend had discussions with the United States on these matters? The question of protectionism in Europe and the increasing interest of the United States in south America as a result of that is developing. Has my right hon. Friend observed any change in the United States position? Why are we taking such a specific interest in those countries when it appears that the United States is beginning to take a greater interest in the north-south grid of central and south America, and in the developments that that might have with respect to protectionism and the European Community?

Mrs. Chalker: As the right hon. Member for Tweeddale, Ettrick and Lauderdale (Sir D. Steel) has already said, the United States has always taken a

tremendous interest in central and south America. It has also taken an interest—one might not always describe it as a free trade interest—in what happens to products coming not only from those countries, but from countries further afield. My hon. Friend may remember that I said earlier in my speech that one of the most important things for the developing ALA countries—and, indeed, for all other developing countries—is trade access. Getting a successful outcome to the GATT round is fundamental. That was underlined by the G7 summit and was repeated by my right hon. Friend the Prime Minister during the summer months. We are determined to ensure, as we have succeeded in doing in the ALA regulation, that there is improved trade for the developing countries. All our EC partners have signed up to that. I hope that I can put my hon. Friend's anxieties to rest on that.
When we come to the Development Council on 28 November, I intend to ensure that the final version of all the documents incorporates and fully reflects the goals that I have outlined in my speech today. I have no interest in programmes that do not meet those goals, They must meet those goals for the sake of the developing countries, for their future, for alleviating poverty, for improving the lot of women in those countries, improving the environment of those countries and, above all, helping them to gain growth in their own economies, which will help their nations more than anything else.

Mrs. Ann Clwyd: I welcome this rare opportunity to debate an aspect of development and co-operation on the Floor of the House in Government time. Once again, the timetabling of the debate demonstrates the dismally low priority that the Government give to aid and development. These vital issues are currently treated as little more than a stopgap, or a filler, in parliamentary business. It appears that only when having run scared of a November election, and thinking that they had parliamentary time on their hands, were the Government prepared to debate these issues. Once again, their approach wholly fails to match the importance that is increasingly attached to the subject by the British people.
Be that as it may, I welcome the chance to debate this topic—particularly the European Community's programme for Asia and Latin America, which does not receive enough attention. The programme, however, now runs at over 350 million ecu a year—more than three times its size just 10 years ago.

Mr. Wells: Will the hon. Lady give way?

Mrs. Clwyd: No, not yet. I have only just started my speech. The hon. Gentleman will be able to make his speech in his own time.
The proposals to reform the framework for Community assistance to Asia and Latin America—

Mr. Wells: rose—

Mrs. Clwyd: If the hon. Gentleman wishes to make a speech, he may do so when I sit down. I am not giving way.

Mr. Wells: rose—

Mr. Deputy Speaker: Order. The hon. Lady has made it clear that she is not giving way at this stage; the hon. Gentleman must not persist.

Mrs. Clwyd: The proposals—

Mr. Wells: rose—

Mrs. Clwyd: If the hon. Gentleman would wait until I have completed more than a paragraph of what I have to say, we could start the debate. Until then, perhaps he will allow me to develop my theme.
The proposals to reform the framework for the Community's assistance to Asia and Latin America come at an important time for both regions, particularly in regard to their relationship with Europe. In Latin America, countries are striving to build economies to consolidate the democratic gains of recent years— although, sadly, that process has suffered a serious setback following recent events in Haiti.
After a disastrous decade of debt and economic decline, which has left Latin Americans 10 per cent. poorer than they were a decade ago, some glimmers of economic hope are now appearing in countries such as Mexico and Chile. Despite the bullish reports from some parts of the financial press, however, we should make no mistake about the fact that formidable obstacles still face the continent—and, paricularly, its poorest people. Sluggish levels of world growth, the legacy of a decade of debt-induced cuts in social and economic investment, slow progress in the dismantling of developed countries' trade barriers and unsustainably high levels of debt service remain.
In central America, there is now real hope of a peace settlement, particularly in El Salvador. Once peace is secured, the task of reconstruction is massive. There is the need for physical rehabilitation, not least from the devastating environmental impact of war—including the destruction of thousands of acres of forest by Government bombing raids in the Morazan region of northern El Salvador over recent years. There will also be the need to support agrarian reform measures, to give the poor and landless a fairer share of the country's land and to act to put right one of the central popular grievances behind the long-running and bloody war.
In Asia, the challenges are even greater. It shares with central America some of the challenges of post-conflict reconstruction—particularly in Cambodia, with the planned signing of the peace accord on Wednesday. First, the remaining political problems must be confronted. In particular, Britain, through the Community and the United Nations, must not accept a return to positions of power for the Khmer Rouge representatives implicated in the genocide of the Pol Pot era, as seems all too possible.
Secondly, Britain must end a shameful aid and trade embargo that has continued to punish one of the poorest countries and peoples in the world. Community aid will have a crucial role in helping Cambodians to rebuild their country's shattered economy. I hope that the Minister of State will say something about that later. Will she also comment on the position in Vietnam and tell us what she will do to ensure that that country, which for so long has been denied crucial development aid, receives that essential assistance. Although the region which, apart from a few important exceptions such as the Philippines, has not normally been thought of as debt-troubled, the recent financial crisis in India should warn us against complacency.
The starkest challenge is posed by the level of poverty in Asia, and I am glad that the Minister placed such a strong emphasis on alleviating poverty. More than 70 per

cent. of the world's poor—struggling to live on less than 50p a day—live in Asia. In south Asia, people can expect to live on average to just 56 years of age—10 years less than in Latin America. Only 65 per cent. of primary school-aged children are enrolled for primary school education in south Asia and that is just above the figure in sub-Saharan Africa.
If the European Community is to play a full part in the concerted efforts to cut world poverty—something that the World bank development committee reaffirmed in Bangkok last week as the highest priority of the international development community—it must allocate adequate resources to Asia.
The Minister referred to a high priority for women. I hope that she can tell us what percentage of the aid will be directly focused on women. When questioned in the past about the direction of poverty alleviation and its aid programme for women in developing countries, the Overseas Development Administration has provided completely inadequate answers.
The relative allocation of Community aid between Asia and Latin America is one of the key points in the new guidelines that we are considering. There has been a long-running debate in the Community on that issue, and I am glad that there is reference to that point in the ODA's memorandum. Given its relative poverty, Asia continues to be considerably underfunded by the Community. Although no explicit financial split is set out in the document, there are clear and worrying references that imply a move away from Asia. For example, article 2 states that all developing countries in the regions are eligible
for development assistance and economic co-operation",
opening the way for more aid to be pushed to Latin America. Specific new criteria added for widening the programme—for example, support for drug substitution programmes—also implies diversion of aid away from the poorest countries.
We believe that the proposed guidelines could lead to a diversion of aid from the poorest towards bringing Community businesses the greatest commercial gain. Aid will be used instead, as the Commission states,
to promote European investment in the ALA developing countries.
The gradual loss of focus on the poorest countries and the poorest people is a worrying trend that must be actively resisted by the Government. I hope that the Minister can assure us that the guidelines will not be allowed further to tilt the balance of the Community's programme with non-Lomé countries away from Asia, where the greatest levels of poverty lie. What is the Minister doing to ensure that the overriding priority of helping the poorest is compatible with promoting Community business under the guidelines?
There are also serious concerns about the programme over funding. The Council of Ministers recently attempted to cut elements of the Asia-Latin America programme to find money for the 400 million ecu aid package for the Soviet Union.
Did the Minister support the Council of Ministers' proposal to cut 14·8 million ecu in commitments from budget line B7/3005 for support for small and medium-sized businesses, including the co-operatives in Asia? Did she, in the Council of Ministers, support the proposal to cut 10·8 million ecu of commitments from budget line B7/3015 for similar activities in Latin America?
Although the cuts have been opposed by the European Parliament, the attempts to cut aid to Asia and Latin America belie the oft-repeated assurances by the Commission and by the United Kingdom Government that the south will not lose out to the east.

Mr. Hugo Summerson: I am sure that the hon. Lady will find time to welcome the proposal by my right hon. Friend the Prime Minister to remit entirely the debts of the poorest countries to the tune or £550 million.

Mrs. Clwyd: Of course one welcomes that move by the Prime Minister. Opposition Members have been urging it for a long time. That leaves, of course, a percentage still owed by the poorest countries to the commerical banks and to multilaterals. I hope that the Prime Minister will also address that point in future proposals to allay the debt of some of the poorest countries. I hope also that he will apply himself to the debts of some middle-income countries, which are equally worrying and in respect of which we have also been urging some debt relief.

Mr. Corbyn: Although any relief of debt must be welcome news for the poorest in the poorest parts of the world, my hon. Friend will be aware that the Prime Minister, in making his statement, also put down considerable conditions, insisting on the adoption of market economy measures which have been a palpable failure in this country and in many other parts of the world. That is a condition on which the British Government would be prepared to write off those debts.

Mrs. Clwyd: I thank my hon. Friend for reminding us of that point. I am sure that his remarks will not fall on deaf ears on the Government side of the House.
The other major change included in the document is the proposal to end the present practice of the EC aid programme to Asia and Latin America being run on a system of single-year cycles. That practice has been rightly criticised as clearly working against long-term planning. As the Minister said, we welcome the principle of changing to multi-year programmes, allowing the Community and recipients to build a proper long-term strategy for its aid and economic co-operation in Asia and Latin America which is badly lacking at present.
There are also other welcome elements in the guidelines, some of which the Minister mentioned, such as the stress on human rights and democracy, the undertaking to direct aid towards the poorest people, and references to support for the human dimension of development, notably the role of women. As I said, much lip service has been paid to directing aid towards women. I hope that the ODA will have specific targets and be able to answer specific questions on that point.

Dr. Godman: With regard to improvements in human rights and the development of parliamentary democracies in Latin American countries which, rightly and properly, are to receive this sort of assistance from the European Community, is my hon. Friend aware of any discussions with United Nations officials concerning that aid? I remind her that Mr. de Soto and his colleagues have performed admirable work on behalf of the United Nations in El Salvador and Guatemala. Perhaps their experiences in those countries might help the European Community's deliberations concerning those criteria.

Mrs. Clwyd: I thank my hon. Friend for making those valuable points. I hope that the Government will also be even-handed in their consideration of support for human rights. There is plenty of evidence that the Government have not been even-handed and that, depending on their attitude towards the rulers of certain countries, they will turn a blind eye to the abuse of human rights in those countries.
I agree with the reservation in the ODA memorandum on the vagueness of the guidelines on environmental vetting. The issue of implementation is even more important. In practice, the record of EC aid to the regions is appalling. Let us take Bangladesh as an example. At the end of last year, the EC Court of Auditors produced an utterly damning report on the record of the Community's programme to that country between 1976 and 1988. One of the report's criticisms was that none of the 12 major problems looked at, which accounted for nearly three quarters of the total spent in the period, achieved its main socio-economic objectives. It stated that most projects set unrealistic completion dates. A cotton project that was supposed to take three years was still less than three quarters implemented after eight years. One cereals project started three months after it was supposed to finish. The assessment and monitoring of the EC programmes was weak.
Aid was given to improve veterinary services for livestock, assuming that that was behind the shortage of animal power for ploughing and other tasks in rural Bangladesh. In fact, the shortfall had more to do with the lack of fodder and of credit for farmers to buy animals, which the project did nothing to tackle. Monitoring was poor, which is hardly surprising because the report reveals that, since the middle of 1986, only one person in Brussels had responsibility for monitoring the 65 EC-funded infrastructure projects in various countries, and that he did not visit Bangladesh once.
It is not only in Bangladesh that EC aid has failed to reach the poorest. To choose just one example from the Latin American programme, 18·5 million ecu was allocated for the Central American civil aviation authority to equip the airline network with radar—hardly much help to the struggling peasant farmers or agricultural workers on poverty pay across the region.
The lessons from Bangladesh and from other EC programmes in Asia and Latin America are that, although it is important to have better guidelines for Community aid to Asia and Latin America, it is even more important to ensure that the guidelines are followed and properly implemented.
Ministers have not been slow to agree about the shortcomings in EC aid—almost as a way of diverting criticism from the bilateral programme—but the Government's attitude to the scandal of wasted EC aid has been as ambiguous and confused as their attitude to Europe in general. They distance themselves from the shortcomings of EC aid by shifting the blame on to the Community, as though they were not part of it. It is imperative that the Government do more to be actively and constructively engaged in ensuring that programmes under the new guidelines are carefully assessed, monitored and evaluated in practice. Perhaps our European partners would pay more heed to what the British Government have to say about the quality of Community aid if we were seen to be serious in our commitment to the overall level of aid funding instead of cutting aid to just 0·27 per cent.
of GNP last year—the lowest ever on record and something that the Minister herself told us last week that she regretted.
With a Labour Government in place by June next year for the start of Britain's presidency of the Community, we will act to ensure that Britain's aid programme is adequately funded and that Europe's aid programme to Asia and Latin America is effectively used in the battle against poverty.

Sir Michael Marshall: Having just returned from Asia and Latin America. I am glad to have this opportunity to say a few words in this debate. When I read the guidelines for co-operation with developing countries in Latin America and Asia, I was worried about the bloodless nature of the prose. When I considered some of the problems with which both Latin America and Asia are confronted, I was anxious about the way in which the proposed implementation would work in practice. Also, the sanctions to which my hon. Friend the Member for Hertford and Stortford (Mr. Wells) referred earlier seem to call come matters into question.
Having heard my right hon. Friend the Minister, I was somewhat more reassured, although I still wish to put some questions to her. I appreciated in particular the robust ending of her speech, in which she said that the Council of Ministers, as I would hope, is there to make political judgments, to take the bloodless prose and to consider some of the practical problems and what can be done to resolve them.
In paragraph 5.2.2, the guidelines state:
the Commission considers it neither desirable nor possible to retain the original objectives for Community aid to the developing countries in Asia and Latin America. if only because the needs of these countries have changed.
That is undoubtedly true, but it is precisely because of those changes that I suggest that there is an opportunity perhaps to sharpen up the way in which Community aid, along with bilateral aid, might be directed.
One must observe in Latin America the truly remarkable political development of the ending of so many "murky military dictatorships", as my right hon. Friend described them. That presents us with an era ahead in which Latin America and Europe will come closer and closer together. That is to be greatly welcomed. It is perhaps indicative of that that, at the Inter-Parliamentary Union conference just over a week ago, Spanish was introduced as a third main language, after many generations of having English and French as the only effective official languages. That is a sign of the times, and something which, again, I welcome.
Within the document, there are some good thoughts on the environment and so on and, indeed, on the general framework of how economic aid to those countries might be applied. But I wish to concentrate on drugs for a moment in relation to aid to Latin America. It seems to me that the stated objective of helping to stamp out drug production is all very fine, but I am worried about the degree to which aid seems to be specific, in the sense that it is not coupled directly with whether there is a total commitment to stamping out drug production.
I hope that my right hon. Friend can assure me that, at the political level, assessments will be made to ensure that

aid which is given throught the community does not go hand in hand with economies which are being successfully driven forward by ever-increasing drug production. There should be some relationship there. There should be some willingness to withdraw, if that is seen as a feature of certain countries.

Mr. Corbyn: In the hon. Member's discussions with people about the awful problem of drug production in Latin America, was the problem raised with him that many farmers are paid such disgracefully low prices for legitimate crops that they produce that to some extent they feel themselves pushed into drug production against their wishes, and certainly without any wish to pollute our youth in Europe or north America with the consequences of their drug production, the profits from which go. of course, to the millionaires in between?

Sir Michael Marshall: The hon. Gentleman makes a fair point. The obvious corollary is surely to ensure that aid goes to helping to resolve that balance. That is the type of aid that I would like to see.
I shall be brief, because I am aware that others wish to speak, and we have only a short time. Turning to the problems of Asia, I want to concentrate not on the environment, population or drugs, which are well known problems, but on human rights. The problem of human rights in Asia is massive. Before I deal with it, I must cross swords briefly with the hon. Member for Cynon Valley (Mrs. Clwyd). She suggested that we should simply continue to push aid into Asia-Pacific on an ever-increasing scale. In touching on that problem, she ignores an important and significant shift within the Asia-Pacific region.
Anyone who has had the chance to attend Asia-Pacific conferences recently must be greatly encouraged by the way in which more and more countries within the region are beginning to see a commitment—indeed, a positive moral imperative—to assist in the process of development within the region. One can cite the constructive attitude of Malaysia, Singapore, Japan and Korea in that regard. Therefore, one should not automatically assume that there is a straight, upward European progression. It must be related to what is being done in the region. Given that resources will always be limited, one should not just take a straight, upward-curve view of life about assistance to Asia. One must balance those two factors.
I was pleased that my right hon. Friend stressed human rights. Against the background of Harare, with the tie in the Commonwealth of aid to progress on human rights, we see a standard that I should like to believe could he more widely spread throughout Asia. The human rights problems are well known, and I do not need to repeat them in detail.
There is a long way to go on rights for women and children. The House does not need to be reminded of all the figures, but in Asia, particularly in the Indian subcontinent, the overwhelming number of illiterate women is one of the greatest single barriers to progress for their future and that of their country. I hope that my right hon. Friend, if not tonight then in future, can let me know how much aid is spent, not just on women and children as the hon. Lady requested, but on that specific area of illiteracy, which is the greatest challenge of all.
In many areas of human rights, whether on a country's record on political prisoners or on the rights of ethnic


minorities, our aid, whether bilateral or through the Community, must increasingly look for progress and should indeed include some sanction if we cannot find progress. In short, what has been said in Harare sets the standard which should apply not only to our bilateral aid, but to the aid that we are discussing tonight.

Mr. D. N. Campbell-Savours: I shall he only a few moments and shall follow the hon. Member for Arundel (Sir M. Marshall) in his comments, particularly about south-east Asia.
We should treat the hon. Gentleman's proposition with some importance. There is a great scope for many of the major manufacturing countries in south-east
Asia— certainly Japan, Hong Kong and the other countries that he mentioned—to play a far more responsible role in developing the countries on their doorstep, which in many ways are underdeveloped. However, there is a danger, as I am sure that the hon. Gentleman will agree. Japanese aid policy is often determined by self-interest, and if the Japanese were given almost a monopoly arrangement on, for instance, the right of access for aid, in the long term they might abuse it and turn some of those smaller countries virtually into satellite manufacturing states, creating a Greater Japan and developing further industrial strength for it. One should bear that consideration in mind, particularly when considering the role of Japan in that area.
I wish to tackle tht Minister on the report of the European Court of Auditors. A couple of years after I was first elected, my hon. Friend the Member for Blackburn (Mr. Straw) made a notable speech in the House about a Court of Auditors report. Those reports are rich pickings, and we now have them on Community aid. It seems, however, that little changes. The right hon. Lady said that a couple of staff from the Department has been seconded to the Community to advise, in order to secure higher standards in the quality of aid. I am not altogether convinced that that is sufficient. The European Parliament needs to set up a Public Accounts Committee, similar to the operation that we have in the United Kingdom. It is due to lack of accountability, in terms of not being able to ask questions of the civil servants in the Commission responsible for implementing these policies, that no action is taken to rectify problems.
The right hon. Lady should take that principle on hoard, and I shall press it as and when a Labour Government are elected—because I believe that European institutions should be kept far more accountable in terms of the public moneys that they expend.
There was a statment tonight on the tapes about the Vietnamese boat people. I had expected far greater numbers of people to be involved in the agreement, but there are fewer than 300. A number of my hon. Friends have visited the camps, as have Conservative Members, and the conditions are quite appalling. The Hong Kong authorities are struggling to resolve an insoluble problem. The international community is not interested in playing its part in resolving the problem. Indeed, if people from those camps were invited to more developed parts of the world, that would only lead to an even greater invasion of people from Vietnam into Hong Kong and other parts of south-east Asia. Some people who are genuine refugees will always have a right to move to different parts of the

world, but we must not set up a system which simply invites more and more people to Hong Kong and south-east Asia.
How can we get out of the mess? The only answer is for the western powers, and particularly the European Community, to change their attitude to investment in Vietnam. That country is crying out for investment. If it thought that the investment tap was to be turned on, it might see the problem of the resettlement of its people in a different light. I hope that the right hon. Lady will consider that suggestion.
Tonight my hon. Friend the Member for Cynon Valley (Mrs. Clwyd) and I had an interesting dinner with a professor from Strathclyde university. The subject of our conversation was the attitude of successive British Governments to the export of technology, particularly in relation to power generation. The Minister will be aware that my hon. Friend has tabled many questions on this matter recently and that there have been some heated exchanges on ATP—aid and trade provision—policy.
If the Minister was honest with herself, I am sure that she would accept that problems arise with the technology involved in such programmes. I do not believe that those problems can be abolished overnight, as they are part of a deep-rooted section of British industry that has somehow managed to graft itself on to part of the aid budget.
It could he argued that one should start reprofiling the available aid into technologies which meet environment-ally acceptable criteria. The non-fossil fuel obligation is an interesting example of such development. If one creates a market, industry then moves to react to those new conditions. Is it not possible for the Government to reprofile British industry exports that are ATP-supported or tied-aid-supported towards projects which are environmentally acceptable?
In recent months, the Minister has made some commendable speeches on good governance. The Foreign Secretary also made a good speech on the subject in Westminster Hall about six months ago. Could the right hon. Lady start developing the case for changing the nature of our exports in this area towards such environmentally acceptable projects? I accept that the Minister might claim that she is already doing so, but that this is not coming through in the presentation of policy.
I have spoken to those who work in the relevant agencies and they remain unconvinced at this stage that meaty negotiations are taking place with British industry about changing the profile of the exports. The problem is that, unless major initiatives are taken and the Government lay down far stricter criteria on what projects they are prepared to support, we shall stick to the old pattern of ATP allocation, with all the dangers and environmental instability that that can create in some parts of the world. I make those points on the back of this debate because much of that technology is going into the areas to which we have referred tonight.
Finally, I give an example of where that could have been done but was not. We fought a war in the Falklands in 1982. The Ministry of Defence spent hundreds of millions of pounds on logistical support during and after the war. Instead of sending vast amounts of oil for power generation there, why did we not send windmill technology, which is now very advanced? One windmill can produce three quarters of a megawatt of electricity. Only 1,800 people live in that part of the world, so a couple of windmills would provide electricity for most of the


Falklands islands—certainly enough for the south of the islands, where most of the people live. Instead, we sent ships loaded with oil.
That simple proposition helps to concentrate our minds on the fact that there are other ways to deal with problems of power generation, which do not require the burning of fossil fuel. Yet they arc available in the form of fairly cheap technology.

Mr. Jim Lester: It is a pleasure to follow the hon. Member for Workington (Mr. Campbell-Savours) and find that I agree with every point that he has just made.
I have always understood that our proposals for change in the European Parliament are about financial and public accounts control, and to give the European Parliament an opportunity to question the European budget as we do in the House.
I follow the hon. Gentleman's point about the Vietnamese boat people. In spite of the pros mentioned by my hon. Friend the Member for Arundel (Sir M. Marshall), all the documents show a convergence and improvement that are to be welcomed. We also welcome the efforts of my right hon. Friend the Minister and her officials in bringing that about. It is clear that, in those areas of the world, unless there is a convergence and a common policy on development, we shall not chip away at the huge problems which we all recognise exist.
I shall mention three countries for which there is a sense of urgency. First, I follow the hon. Member for Cynon Valley (Mrs. Clwyd) in mentioning Cambodia. Those of us who have been involved in that country's agonising moves toward the ending of a war and its potential for re-establishing itself in the community of nations look forward to the signatures of the various parties on Wednesday and the setting in motion of the virtuous circle, rather than the other one, which has been the source of such despair for so long.
We are fairly sanguine about that situation and know that it will need a great deal of diplomacy and skill before things are seen to be happening on the ground. It would help if we could make a statement on our attitudes toward the new Supreme National Council and the problems of resettlement, which is one of the subjects that concern us. The Secretary-General is well aware that a hurried resettlement, or driving across the border by any faction that has people in Thailand, would be deplored by all of us.
Statements about resettlement and the shortfall in funds that is likely to be declared in Paris would be a helpful way for us to play a part in bringing about the changes in Cambodia that we want to see. Those of us who have been there know the scale of need in the short term, but it is a pump-priming exercise, because Cambodia is not like sub-Saharan Africa. but has tremendous resources and potential. Therefore, any aid that comes from this country and Europe will be of a pump-priming nature.
One aim which has been realised by visiting experts and which could be achieved relatively quickly would be to provide the know-how ability to raise taxes from the population who, at present, pay no taxes although they have a thriving market economy. We are not talking

merely about providing big money in terms of redevelopment, roads, telecommunications, hospitals and resettlement, but of rapidly providing the new Government with the knowledge of how to operate a modern state.
I totally agree with what the hon. Member for Workington said about Vietnam. Those of us who know that country know that desperate poverty is the driving force behind people leaving and must be alleviated. That is where human rights enter the argument, because it is a matter of linking progress with development, but not denying the development in the short term. Vietnam probably has the most significant environmental problems of any country in Asia. I shall not go into the reasons for that, because everyone recognises the enormous devasta-tion caused by the war.
There is tremendous scope for giving Europe the opportunity to break the log jam of the American embargo on Vietnam. Whatever help we give, we are essentially involved in a pump-priming exercise. With the right level of short-term aid, Vietnam could become a second South Korea in a short time, because it has an industrious, able people, and although it is not over-blessed with resources, it has a considerable potential market.
I should be grateful if my right hon. Friend the Minister could give some sign of how she hopes to lead her European colleagues on 28 November in discussions on those countries, because we are anxious for them to rejoin the family of nations and a prosperous south-east Asia so that we can concentrate even more on different countries in sub-Saharan Africa and other parts of the world that will never have the same opportunity.
One takes a harder line on human rights in Burma, which is an essential producer of drugs. So far, the aid that has gone to Burma from United Nations organisations has been solely connected with drugs. We have all stopped our aid programmes to Burma because of its appalling human rights record and its rejection of the democratic elections held two years ago. We have to weigh the relative evils: drug production and denial of human rights. If we are to deal with Burma, which is a major producer, how can we ensure that any assistance to deal with drugs is ring-fenced so that it specifically addresses that problem and gives no encouragement to what I consider to be the illegal regime currently in control in Burma?
There is tremendous opportunity throughout the world at present. There has been change in Latin America and Asia in districts where it seemed impossible to foresee any improvement, and the same progress can be repeated in Africa and eastern Europe. The opportunities for the transfer of resources that Europe should be contemplating are tremendous. That is the answer to the economic migration that concerns many people, including my right hon. Friend the Prime Minister. Therefore, we should seriously debate the overall level of aid that we are prepared to give from the European Community, and ensure that it reaches the target countries in good time and at the right time to have the maximum effect.

Mr. Jeremy Corbyn: I congratulate the Minister on holding this debate at a relatively early hour. The last similar debate was held, as I recall, at about 3 am.
I represent a dissenting voice amidst all this unanimity. I note that the Minister looks pleased at last. There is something wrong with the approach being foisted on the poorest countries in the world. The continent of Latin America, for instance, has gone from having a trade surplus 30 years ago to having a significant deficit. It is in debt; low prices paid for commodities sold by the continent have contributed to that debt, as have the high interest rates of the past 10 years.
Meanwhile, there have been enormous social upheavals. Rio is now a vast sprawling metropolis surrounded by huge shanty towns. Most other large cities throughout Latin America are the same. Local infrastructures and communities are breaking down. With that breakdown go violence, crime and poverty.
Drugs and drug production represent another major factor. That issue must be faced now and in the future. It is the poor of the inner cities of north America and of western Europe who suffer the consequences of this drug problem, and it is the poor in the poorest countries of Latin America who produce the drugs. In the middle somewhere are the millionaires whose hands are untainted by these drugs. At one end of the scale, people are forced to produce drugs because they cannot produce anything else that will pay them a reasonable price—and the results are seen on our streets.
The attitude now prevalent seems to be that the only solution to Latin America's problems is a reduction in the activities of the state, which should concern itself only with security and the armed forces. The answer, it is said, lies in a rapid increase in export promotions and of inward investment to the continent. The result is the horror stories that we hear—of schools and hospitals being closed and of water purification programmes being put back—all to pay off debts on the edict of Washington via the World bank and the IMF.
I was pleased when I first heard the Prime Minister's statement on the radio last week that he was prepared to write off some of the debts of some of the poorest countries. The inevitable sting in the tail, however, is that writing off those debts appears conditional on the countries adopting what the Prime Minister calls market economics as a solution to their problems.
It is the utmost arrogance on the part of western European Governments, who have deliberately encouraged low prices for the commodities produced by these countries—and the high interest rates that have contributed to their indebtedness—to claim now that they are prepared to write off some of their debts in return for the adoption of market economics, knowing full well that those economics led to enormous social upheaval in the countries. Such arrogance resembles that of certain 19th-century English statesmen and their colonising activities around the world.

Mr. Lester: Will the hon. Gentleman give way?

Mr. Corbyn: We should be thinking a little more seriously about the consequences of some of our policies for the desperately poor people of Latin America.

Mr. Lester: Surely the hon. Gentleman understands that there is no point in writing off a country's debts without changing the policies that caused the debt in the first place? The whole point of market economics is to effect change so that those debts will not recur. Writing off debts and leaving them to accumulate again helps no one.

Mr. Corbyn: I agree with the hon. Gentleman and hope that that does not ruin his future. The policy which caused the debt in the first place must be changed. There is no point in writing off the severe debt of those countries without looking at the policies. I have here the OECD list of such countries. The policies that need to be changed are not those relating to the degree of social activity of the state in those countries, which is usually minimal. I want to see policies that will lead to significantly higher commodity prices and much lower interest payments so that those countries will be able to develop. The hon. Gentleman seems to advocate some form of punishment of the Governments of many of those countries.
The rubric being foisted upon the poorest countries is that the solution to all their problems is the adoption of a free enterprise economy. The pinnacle of that is the GATT negotiations, the obsession of the former Prime Minister, with the idea of a world free market in food. If ever there was a manifesto for free enterprise for the big agribusiness countries of western Europe and north America, that is it. That would be the consequence of the GATT policies that the former Prime Minister sought to pursue.
We must pay attention to the environmental and social consequences and the long-term economic relationship arising from such policies. Despite all the talk about aid for the past 20 years, the reality is that the gap between the richest and poorest countries has got bigger and in many cases the economies of the poorest countries are contracting. We should pursue policies that will help to alleviate social problems and allow economies to expand in a sustainable way rather than in an environmentally destructive way. I know that the Minister has spent some time on that issue.
My hon. Friend the Member for Cynon Valley (Mrs. Clwyd) spoke about El Salvador and the unfairness of its land distribution system. I think that she said that the basis of many of that country's problems arc the maldistribution of land and poverty. The same applies in Nicaragua, just across the border, where the Sandinista Government have been defeated in an election that they themselves called. The consequences of the free market economy being thrust upon Nicaragua are that co-operatives are being broken up and the big landowners are returning. Much of the social deprivation that brought about the Sandinista revolution in the first place is returning.

Mr. Jacques Arnold: Why was not land reform carried out in Nicaragua during all the years of the Sandinista Government?

Mr. Corbyn: The hon. Gentleman is wrong. A great deal of land reform was carried out. The hon. Gentleman may not have been listening carefully to my speech. I spoke about the return of unreformed land in Nicaragua to large owners who are returning and being given their land back by the current Government. That is one of the problems recreating the inequalities that brought about the Sandinista revolution. My hon. Friend the Member for Bristol, South (Ms. Primarolo) visited Nicaragua during the time of the Sandinista Government and can confirm what I have said.

Ms. Dawn Primarolo: Yes.

Mr. Corbyn: Perhaps in winding-up, the Minister will tell the House about the trading relationship between the EC, including this country, and Cuba. Cuba removed


United States influence in 1959 and has suffered 30 years of a United States economic blockade. As a means of survival, Cuba became a full member of Comecon and its economy was greatly linked to those of eastern Europe and the Soviet Union. Now it has to pay for all its imports with hard currency—[Interruption.] Conservative Members may laugh, but that has resulted in severe shortages for the Cuban people. The Government of Cuba are making considerable efforts to export medicines and medical equipment and to diversify their economy to give self-sufficiency and export fresh food and vegetables. Cuba produces many goods which could reasonably be imported into Britain and western Europe. In return, this country and western Europe might like to export to Cuba such things as technical equipment, vehicles and electrical technology.
I hope that the Minister will not allow the Government to be persuaded by President Bush and others in the United States into further isolating Cuba, which has made considerable achievements in education, literacy and health. It is probably the best-educated and most literate country in Latin America: that is a great achievement for a country that was in abject poverty in 1959.

Mr. Jacques Arnold: I wonder whether the Cuban Government might be prevailed upon to go for the biggest achievement of them all and to have a truly democratic election. It is now the only Hispanic Latin American country not to have had a proper election of its Government by the people.

Mr. Corbyn: That is rich, coming from the hon. Gentleman. He talks about democracy in Latin America, but I remember him, only two or three years ago, at 4 o'clock in the morning, desperately defending the Pinochet Government. The human rights record of the United States, in its activities in the region, is abominable. I am asking the Minister what trade conditions are being imposed on Cuba and what trade will be allowed in future.
What is being given to Sri Lanka and is there any monitoring of how that aid is used? What controls are there over the final destination of that aid? The situation there is appalling. The abuses of human rights are serious and there is great poverty. It would be useful if the Minister could address herself to those questions.
I hope that we can come back for futher debates on the relationship between northern and southern countries. We cannot go on observing the growing gulf between the richest and the poorest countries and adopting economic policies that widen rather than narrow that gulf, create rather than prevent environmental destruction and create greater poverty and urbanisation, rather than promoting sustainable development.
debatge.

Mrs. Chalker: With the leave of the House, in the time left to me I shall try to respond to as many as possible of the points made in this interesting debate.
It is evidence of the consensus in the House that hon. Members seemed to agree with most of the factors that I outlined in my opening speech, such as European Community co-operation in aid programmes with Asia and Latin America. Good government, with all its

implications—including elections in Cuba—seems to be the order of the day. We want not only the Community aid programme, but all aid programmes, to have a poverty focus and an emphasis on the special needs of women. We want conservation of the environment to be a requirement of all aid programmes, not just that of the EC, which is the subject of our debate. We want to ensure that we help these countries in their great fight against drugs. We need effective measures to raise project quality. I hope, although it has not been mentioned in the debate, that hon. Members will agree that all aid programmes should give support for population planning and family health, because these are critical to the well-being of the developing world.
We shall continue to press other issues in other Community programmes. We have to achieve many objectives through the international financial institutions, particularly the World bank, as well as in the EC and our bilateral activities. I thank my hon. Friend the Member for Broxtowe (Mr. Lester) for his comments on the improvement and development of Community aid. I can tell him that it is certainly better than it was five years ago, but the reason for having strict guidelines and for ensuring that they are implemented is to improve them still further. My hon. Friend the Member for Arundel (Sir M. Marshall) also referred to that. While I am mentioning him, may I congratulate him on his election as president of the Inter-Parliamentary Union, which is welcomed by his colleagues in all parties.
Some hon. Members commented on the quality of aid, as did I. The hon. Member for Workington (Mr. Campbell-Savours) asked about the accountability of the Commission in delivering its aid programme. The Court of Auditors report to which the hon. Member for Cynon Valley (Mrs. Clwyd) referred demonstrates that there are controls in the system. Their scope may need broadening, but they exist and it is Britain that has emphasised for many years the importance of proper evaluation. Progress has been made, especially in the past two or three years, and I shall continue to press for further progress. However, I agree that aid quality control mechanisms within the Commission are not as tight as we want them to be. There is more work to be done and we shall continue to do it.
We must continue to press for accountability from aid recipients because accountability is an integral part of good government. It is not enough for the Commission to ensure that the aid is being dispatched properly—it is critical that the aid is properly utilised, so donors must he subject to the highest standards of accountability and control. We must ensure that that control extends to the recipient countries.
We have covered much ground this evening, but I especially want to take up the points made by the hon. Member for Cynon Valley about women. She asked what percentage of the projects are of direct benefit to women. I fear that she misses the fundamental point, which is that women bear the overwhelming burden of poverty in the developing world. They and their children are at the bottom of the heap, which is why every programme must have a poverty focus to try to lift that burden from them. To focus on poverty is to benefit women directly. It is too important an issue to aim at targets which could quickly become meaningless—all poverty-focused aid must and should benefit women. I hope that my hon. Friend the Member for Arundel, with whose comments on the key


role of women in development I concur, will accept that. We believe that it is crucial for the development of these nations that aid is directed to poverty alleviation and thereby helps women.

Sir Michael Marshall: I asked my right hon. Friend about illiteracy and the slave labour of women and children at work.

Mrs. Chalker: If I started to talk about slave labour, we might be here beyond the time allotted. However, I have sought to deal with the question of illiteracy during my two and half years with the Overseas Development Administration. To enable women to read and write is to enable them to start to take their rightful place. Therefore, our programmes seek—as do projects such as the Aga Khan Foundation projects which I mentioned—to target women to enable them to play their full role.
I shall respond to what the hon. Member for Cynon Valley said about the split between Asia and Latin America. She asked whether the emphasis was moving away from the poorest countries. I assure her that it is not, and that we shall not allow that to happen. I remind her that the ALA programme began as a consequence of British accession to the Community because of our close relationship with the poor countries of southern Asia. It is a key objective in our present discussions and will remain so.
Far from promoting EC business interests, the bulk of the ALA programme goes to the poor countries of Asia and will focus on the poverty alleviation that I have mentioned. There will, of course, be encouragement of private investment for the more developed countries of Latin America; that is part of generating growth in their economies. However, as far as we can see—and the intentions of our colleagues in the Community are the same as ours—we shall focus specifically on poverty alleviation, and that means on Asia.
Several hon. Members have asked me about Cambodia and Vietnam. There is no aid and trade embargo on Cambodia. Last year, we extended our British non-governmental organisation joint funding scheme to Cambodia. We encouraged Voluntary Service Overseas to start work there and we made more than £ 1 million available through the United Nations agencies. With the settlement, which we hope is about to be signed on Wednesday, we shall build on those measures, and we shall make a specific United Kingdom announcement very shortly about what further we can do. We will build on the work that we have done in the past, but we will also go into new areas of work.
On Vietnam, and especially on the vexed problem of the Vietnamese boat people, we believe that financial support

for an international programme to assist the reintegration of the returning economic migrants and know-how for the Vietnamese Government's economic reform programme are most important. We will provide those, and details will be announced very shortly.
On the boat people specifically, my right hon. Friend the Secretary of State for Foreign and Commonwealth Affairs has today announced in answer to my hon. Friend the Member for Fulham (Mr. Carrington) a pledge of £3 million towards the international reintegration assistance programme. That is in addition to our substantial share of the European Community contribution to the $114 million international reintegration assistance programme. We know that there is an urgent need for a solution, and we are working away at it. The internationally agreed comprehensive plan of action offers the best way to bring the solution about, but it is essential that we implement it fully, especially the provision that all non-refugees must return to their country of origin.
My hon. Friend the Member for Broxtowe asked me a number of other questions which I should like to answer, but I shall have to do so in writing.
The Community dimension of our programme is increasingly important in our overall development assistance effort. We have worked hard to ensure that the regulation reflects our priorities. I believe that the version on which we finally decide in November will meet that objective. I commend the motion to the House.

Question put and agreed to.

Resolved,
That this House takes note of European Community Documents Nos. 4051/91 and the Supplementary Explanatory Memoranda submitted by the Overseas Development Administration on 18th and 25th February 1991, and 5896/91 + COR I, relating to financial and technical co-operation with developing countries in Asia and Latin America; and endorses the Government's policy on Community aid to Asian and Latin American countries.

Orders of the Day — EUROPEAN COMMUNITY DOCUMENTS

Motion made, and Question put forthwith pursuant to Standing Order No. 102 (9) (Standing Committees on European Community documents),

Orders of the Day — DISABLED WORKERS (TRANSPORT)

That this House takes note of European Community Document No. 4315/91 and the Supplementary Explanatory Memorandum submitted by the Department of Transport on 3rd June 1991, relating to safe transport of workers with reduced mobility; notes that the principle of improved transport for people with reduced mobility is in line with the Government's aims; and endorses the Government's intention to seek amendments to the draft Directive so that it neither undermines the policy aims of the Government supported by its disability advisers nor imposes unreasonable burdens on the transport industries.—[Mr. Kirkhope.]

Question agreed to.

PETITION

Cruelty to Animals

Mr. Simon Burns: I want to present to the House a petition organised by Miss Lisa Steele of Linnet drive, Chelmsford and signed by more than 200 of my constituents who are extremely concerned about the cruelty suffered by animals in the cause of producing and manufacturing commercial sales of cosmetics and toiletries, in spite of protests over many years.
The petition reads:
Wherefore your Petitioner prays that your honourable House will accept and agree to the plea offered, condemning such activities and practices. and introducing more rigid guidelines for proper conduct in these institutions.

To lie upon the Table.

Residential Homes (Leicester)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kirkhope.]

Mr. Greville Janner: I am pleased to have the chance to ask the House to listen to the plea of the residents of Simon lodge, in my constituency, and to those of residents of other old people's homes in the city of Leicester—in areas represented so ably by my hon. Friends the Members for Leicester, South (Mr. Marshall) and for Leicester, East (Mr. Vaz). Those homes are threatened with closure; their residents are likely to be evicted, and it is a disgrace that they are to be forced out of their homes as they approach the autumn, and, indeed, the winter, of their days.
It was Charles de Gaulle who said that life was a great voyage whose end was shipwreck. The proposal to close down the homes means that the lives of elderly people will be wrecked, and the only reason is money. This is placing money—profit and cost—above all other considerations, and it is placing the quality of life at the bottom of the pile of care.
I appeal to the Minister to use his considerable influence to prevent this from happening. Leicestershire county council is one of those unhappy bodies that are hung: it has more Conservatives than members of any other party. Unless the Minister intervenes, they will vote in favour of throwing out the residents of Simon lodge; and giving them the choice not of staying where they are, but of going to whatever private homes—or, possibly, other public homes—they wish to go to. That is a choice that they do not want, because they are contented where they are.
The Social Democrats hold the balance on the council. I have privately appealed to them to join their Labour colleagues in saying, "No: we will not allow this to happen.- Whether they will do so, we shall see. The committee that will make the decision meets on Wednesday. I can tell its members that neither residents, nor their families, nor their supporters, nor their friends, nor the voters in the city of Leicester, will forgive them if they vote with the Tories to close Simon lodge.
Why is this happening? Some of us saw the Minister, who has been good enough to stay up so late to be with us, the other day. Producing the brief that he had received, he told us bluntly that there was concern about the provisions for health and hygiene in the homes. I contacted Brian Waller, who is director of social services and performs an excellent service for the public. I asked him whether there was any fear about the health and safety of my constituents in Simon lodge. He replied:
On the question of health and hygiene and the kitchen improvements, while there are no urgent shortcomings which would cause the Environmental Health Officer to be seriously concerned, the survey work which was carried out showed that the kitchen and other facilities in this 21 year old home need to be siimilicantln, upgraded to modern standards.
I have been to the home many times. I can testify that it is a place where people are happy and well cared for; moreover, it is a decent home on which a great deal of money has been spent. It is clean and well decorated; it is the sort of home where there is a perfectly adequate building, but where what really matters is that people are cared for: The staff have an affection for the residents and look after them, and the residents want to stay.
I put it to the director of social services that this was a home where people were well looked after, and where there was no risk to health. When I spoke to him, he told me frankly that there was no concern about any threat to the residents at present. I pointed out that there would be hazards to health if there were unhygienic circumstances. That must be attended to now: it was not a question of closing the home. He said that there was no such threat.
Of course there is not. It is an excuse. What the authority is really saying is that it wants to sell the place. But we know that a Conservative council wants to buy it. This is not what was described in this afternoon's debate as creeping privatisation: it is galloping privatisation at the expense of elderly people, and that is wrong. It is not what was described in the press as "back-door" privatisation. It is front-door privatisation through the main entrance of Simon lodge, and it is intended to drive out the people who want to stay in that home. They will have to be moved to private homes. Well, there are some very good private homes in Leicester, but there are also some that are not so good.
The Government say that those people should have a choice. If that is the case, they should be able to choose to stay where they are and not be driven out simply because the home will have to he upgraded some day. Many other places will need to be upgraded one day. Even places that are not residential homes will have to be upgraded some day. For example, the Palace of Westminster needs upgrading. I asked at Question Time today why the facilities for the staff of this place are so bad, and I was told that those facilities were to be upgraded. However, that does not mean that this place will be closed down and people will be driven out now.
Closing the home is wrong, and totally lacks compassion. It is unfair to push people out. We are not dealing with the privatisation of a utility such as gas, electricity or water. We are dealing with a home where people live, where they have a good quality of care and life and where they want to stay.
One old lady at the home, whom I will not name, is 92. She has been in the home for 22 years. The people at the home do not want to tell her what is happening, because they fear that to do so would be the end of her. We are dealing with human beings, not with pieces of furniture. No doubt the Minister will claim that it is a matter for the county council, not for him. I cannot advise the council to listen to the Minister. However, the Minister is a cunning, shrewd, intelligent operator, and he knows that Leicestershire will not forgive him if he allows the home to close.
The case is simple. Some money needs to be spent on Simon lodge, but it is a good home in which people want to stay. People live there in a happy, contented, comfy environment, and it should remain open. The care of the elderly means looking after them and keeping them in their own homes where possible. If places like Simon lodge become elderly people's homes, they should be kept open. I appeal to the Minister, and through him to the council, not to close that home but to allow the people living there to continue their good lives in that excellent and happy place.

Mr. Keith Vaz: I thank my hon. and learned Friend the Member for Leicester, West (Mr. Janner) for the privilege of addressing the House on this issue. As he said, we met the Minister last week. This is a unique occasion, as this is the first time that I have seen all the three Members who represent Leicester together on an issue to defend the elderly people of Leicester.
This is one of the saddest debates in which I have taken part—[Interruption.] I am sorry that the Minister is laughing, because this debate is serious. It is also sad because of the way in which elderly people in Dale house, Simon lodge and elsewhere are being treated by the county council as a result of the Government's policies.
I pay tribute to Ben Edmunds, the chairman of the campaign committee at Dale house and to his other supporters who came to London last Thursday and accompanied me to Downing street and to Buckingham palace, and who also joined my hon. and learned Friend the Member for Leicester, West and my hon. Friend the Member for Leicester, South (Mr. Marshall) at our meeting with the Minister.
We want to dedicate the campaign to the memory of Mike Preston, the local county councillor in Humberstone who died only a few hours after launching the campaign and petition to save Dale house. We had hoped that the memory of Mike Preston would live on in Dale house, and we hope, even at this late stage, that Dale house and the other homes will be saved.
If the Minister had cared to visit Dale house he would know that that home provides excellent care. It has excellent members of staff, and the residents want to stay there. At our meeting last week, the Minister said that he did not regard elderly services as a priority.

The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell)indicated dissent.

Mr. Vaz: The Minister said that, and we disagreed with him. We think that it is the most important priority. The elderly people of Leicester need homes such as Dale house, Curzon house and Simon lodge. They are their homes. For people such as Nellie and Tim, two residents who wish to live the rest of their lives in such homes, this matter has come as a traumatic shock. Two of the residents have died since the horrendous proposals were announced.
At the end of a previous debate, the Minister said that to govern was to choose. He provides no choice for the residents of Dale house. He gives them no opportunity. They must either go into a private home or move their home. The Prime Minister, at the end of his speech to the Conservative party conference, said that the theme for the 1990s was the power to choose and the right to own. Those citizens are too old to be able to own, but they should be given the right to choose to remain where they want to remain.
All we want is the money which Parliament should have given the local authority—the £8.7 million that is required as a result of the National Health Service and Community Care Act 1990. I was a member of the Standing Committee which considered that legislation—the Minister was not. By providing that money, even at this late stage, those three homes can be saved. I urge the Minister to place his county before his party and allow those people to remain there.

Mr. Jim Marshall: I apologise for the poor quality of my voice. It is caused by the bug that is going around. I am sure that it has not been generated by the Minister.
I also pay tribute to my hon. and learned Friend the Member for Leicester, West (Mr. Janner) for arranging this Adjournment debate. This is the first time in the four years of this Parliament that the three Leicester Members have been present as a group to urge a coherent policy on the Government. That shows what we and our constituents feel about the closure of the three elderly persons' homes in Leicester.
We must realise that this matter is about resources. Those three homes have been threatened with closure, because, unless they close, the other elderly persons' homes within the county of Leicester cannot be brought up to a standard which would satisfy Government regulations. Those three homes—Curzon home is in my constituency —are being sacrificed because the Government are failing to provide sufficient resources to enable them to remain open.
The Minister is a Leicestershire Member of Parliament. At a stroke, he can remove the threat to those three homes. He can remove the threat that the residents feel, of being dispersed to other public or private sector homes in the country. At a stroke he can allay the fears of residents and of their relatives, who are equally concerned about how their dependents will be cared for in future. I urge the Minister, as a compassionate person as well as a Minister of the Crown—there are occasions when those two roles are incompatible—to exercise discretion and ensure that Curzon home and the other two homes remain open.

The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell): I should begin by apologising to the House that I have to weary it with my opinions for a second time in an evening.
I understand the natural concern that arises in any case where it is proposed that an elderly persons' home should be closed. I understand it particularly in this case because two of the three Leicester Members came to see me last week—the third sent his apologies; he was in Leicester at the time—to argue the case with me. I understand the problem also because I read the local newspapers in Leicester and I am well aware of the background to the case and the concern that has been aroused locally as a result of the proposals which the county council is due to consider on Wednesday.
However, quite apart from the fact that I have read the newspapers and that the hon. and learned Gentleman has come to see me, it is obvious that any closure involves the disruption of elderly people's lives, which is something that we should all like to avoid. There is no argument between us on that, and I understand the concern that the case has aroused.
It is also important that I should make my status clear in this matter. This issue has to be decided by Leicestershire county council, not by the House or Ministers in the Department of Health or in any other Department in Whitehall. There is an important distinction between the social services world and the national health service world. If we were talking about an NHS hospital and a contested proposal to close it, the

matter would ultimately be decided by my right hon. Friend the Secretary of State for Health. It is the tradition in the Department of Health that in such circumstances the Under-Secretary has quite a large input into the decision that is ultimately to be made by the Secretary of State. There would be an appeals system against a proposal to close the homes in question if they were part of the NHS, but they are not—they are the property of the Leicestershire county council.
It is absurd to suggest that every decision that falls to be made by a local authority should in some sense be held, either directly or indirectly, to be the responsibility of a Minister of the Crown. The purpose of local government is to ensure that not every decision in our society is taken by one of the 85 Members of Parliament who are Ministers of the Crown. We have local government to spread decision-making through the community and to have a more plural system of decision-making. One cannot accept the logic of that system if every difficult decision is then appealed to Ministers.
I repeat that this is a decision for Leicestershire county council, not the Government.

Mr. Vaz: The Minister will recall that, during the passage of the Children Act 1989, the Government provided extra resources for its implementation. Why will he not provide Leicestershire with the extra resources necessary for the implementation of the National Health Service and Community Care Act 1990?

Mr. Dorrell: I was coming to resources later, but I will deal with them now. The Government have seen a substantial increase in the expenditure incurred by personal social service departments. In fact, since 1979, such spending has risen by 51 per cent. in real terms. It is absurd to say that no extra resources have gone into social services care—

Mr. Vaz: Not for this legislation.

Mr. Dorrell: Leicestershire county council is responsible for the allocation of its social services budget. It is within the discretion of the county council whether it uses the social services budget for this purpose or for some other social services purpose.
The speech of the hon. Member for Leicester, East (Mr. Vaz) also showed at the very least a misremembering of what I said when he came to see me last week. He suggested that it was my view that care of the elderly was not a priority. That is not my view. My view is that the Government are quite right in the world of social care to pursue the policy that we have described as a "mixed economy of care". We made it clear repeatedly in the "Caring for People" White Paper, if nowhere else— incidentally, at least until today, I thought that that White Paper represented a bipartisan policy—that, in the world of social care, we do not believe that it is necessarily right for the public sector to take upon itself the exclusive obligation to provide social care.
There is an important distinction between our approach to health care, where we have repeatedly made it clear that we have no intention of privatising or of seeing an existing public health institution moved into the private sector, and our approach to social care, where we have said exactly the opposite and where we have repeatedly made it clear that we think that the private sector has an important


role to play. Indeed, we have welcomed the role that it has played in the growth of residential places for the elderly over the past 12 years.
The first point about government policy, as carried out by local authorities, is that we are in favour of a mixed economy of care of private and public sector provision side by side. The second point is the most salient in the current dispute in Leicestershire. We do not think that it is any longer defensible for the public sector to provide residential places for the elderly against different quality standards from those which the public sector insists that the private sector observes. I should have hoped that all three hon. Gentlemen would welcome the fact that the public sector is committed to ensuring that all public sector residential care homes for the elderly meet the same standards as we have required for some time from private sector provision.

Mr. Janner: Recognising that the public sector homes need upgrading, why will the Minister not make available the resources which the county council needs to do so? Is it not inevitable that, as a result of resources being taken away from it, the county council is forced to run down the public sector so as to drive people into the private sector?

Mr. Dorrell: That is precisely the same point as the hon. Member for Leicester, East made. In response to him, I pointed out, as I do in response to the hon. and learned Gentleman, that expenditure on personal social services over the past 12 years has risen by 51 per cent. in real terms.

Mr. Janner: What about in Leicestershire?

Mr. Dorrell: I do not know the figure for Leicestershire offhand. Leicestershire is not out of line with the national picture. There has been a substantial increase in the resources available for social services provision. I was going through the key points of the Government's policy as discharged by local authorities. A third point is relevant in this case. We have repeatedly said that, where a change in the provision by a local authority is planned, the management of that change must take account of the welfare of the residents of the homes in question. In this case, it clearly means that, if there is a policy to close a proportion of county council homes, there must be a transitional plan which respects the legitimate interests and wishes of those who live in those homes today.
The Government's policy has been carried through successfully since 1979 and has resulted in a dramatic increase in the number of residential care places available for care for the elderly. The hon. Member for Leicester, East alleged that care for the elderly was not a priority. Far from it. The policy has resulted in a dramatic increase in provision over 12 years. The combination of our change in the rules on entitlement to DSS benefit and our encouragement of private provision has seen the number of residential care places in Leicestershire available for use by the elderly rise by 49 per cent. since 1979. Public and private sector provision have existed alongside each other, with the growth principally in the private sector. That was deliberately because of the policy of a mixed economy of provision for social care that I described.
We recognise that the delivery of that policy had one significant defect—that it provides too great an emphasis on residential care and inadequate provision for

domiciliary and other support services to reduce the demand for residential care. That is one of the major factors that has led us to propose the changes in community care provision which will come into force in April 1993. Until tonight, that was a bipartisan policy supported by both sides of the House. However, it seems that there is a weakening of support on the Labour Back and Front Benches for the principles of community care.
Clearly, if and when the community care policy is carried out—the social services have a clear responsibility under those provisions to manage the demand for residential care within their budgets against the identified needs of elderly people—it will tend to ensure that a larger share of that resource is used for domiciliary and residential support, daycare facilities, respite care and a full range of proper care for the elderly. Other things being equal, it will also tend to depress demand for residential places.
Against that background, Leicestershire county council has homes below the standards that for some years it has been demanding of private sector providers as well as vacancies in its homes.

Mr. Vaz: There are no vacancies.

Mr. Dorrell: I am advised that there are about 200 vacancies in the public sector in Leicestershire. There is a total provision in the county of just over 1,800 places, of which 200 are vacant.
Thirdly, against the background of community care, the prospect is that demand for places in residential care will not grow as fast in the years ahead as in the past.
Against the background of those three salient facts— homes below standard, existing vacancies and the fact that future demand is unlikely to be buoyant—it does not seem unreasonable for the council to plan to improve the stock of its homes, financing that improvement by a reduction in the total number of places provided. The National Health Service and Community Care Act was passed only two years ago and it has been explicitly the responsibility of local authorities to manage this provision, so it would be absurd of the Government now to seek to second-guess the details, home by home, of carrying out that policy.
The cost of bringing the three homes mentioned in this debate up to the standards required in the private sector is £255,000 for Dale house, £235,000 for Curzon house and £236,000 for Simon lodge. To bring all three homes up to the standards required in the private sector requires costs sigificantly above the average of homes in Leicestershire, which stands at £198,000.
If the county council plans to reduce its provision to bring supply into balance with demand, it is not unreasonable for it to concentrate its reductions on the provision in the city of Leicester, which is where the alternatives are in most plentiful supply.
I simply do not accept that this is the result of Government policy. Expenditure on social services has risen by 51 per cent. since 1979. The management of those resources is in the hands of the county council, and it is to the council before Wednesday night that the hon. Gentlemen's representations are properly addressed.

Question put and agreed to.

Adjourned accordingly at two minutes to One o'clock.